Ashlyn is a 20 year old female, who is very well adjusted. She is currently unemployed, but actively seeking employment. She is enrolled in the local community college, getting her degree in human services. Ashlyn’s plan for the future is to be a counselor for foster children. Ashlyn stated that she has a very deep connection to foster children because she was a foster child until the age of 10 when her grandmother took her and her three siblings in. Ashlyn is doing very well in school, and maintains a close communication relationship with all of her instructors, and student advisor. She is a likable person, and has many friends to whom she can turn to in a time of need. Ashlyn is an outgoing person that loves life. She is also a very outspoken person, who always tells it like it is. Ashlyn is not married, but does have a boyfriend. Ashyln and her boyfriend have recently found out that they are expecting their first child. Her boyfriend is very involved and supportive of her pregnancy, and any decision that she has made regarding this pregnancy. This presentation will document her physical, cognitive, and psychosocial domains. Prior to having Ashlyn take the tests for each domain I asked her 6 questions.
1. How many weeks is your pregnancy?
Ashlyn: I am currently 14 weeks pregnant.
2. Was the pregnancy planned? If so, what factors were involved in your decision to have this child?
Ashlyn: No the pregnancy was not planned, but we had planned on having children later in life, like after I graduated college and we both had better paying jobs. I guess our plan has changed a bit, but things will work out the way we want them to, I’m sure of that.
3. Are you aware of any possible genetic problems in your or the father’s family, and what are you doing about them?
Ashlyn: As far as I know there are no genetic disorders in my family, but in my boyfriend’s family there is a history of deafness.
4. Are there any medical conditions that you suffer from that the doctor is concerned about or should know about?
Ashlyn: Yes I suffer from a mild heart murmur, but I take no medications for it. Also, when I was younger I battled with anorexia nervosa, but I’m doing really well now. My doctor has been informed of this and has told me that he is going to keep an extra eye on me to make sure I don’t lose, but gain weight. He would like me to gain about 25 pounds during the pregnancy. I’m a little scared of what’s going to happen in the future, but as of right now I’m completely ok with gaining the weight for my growing baby.
5. What steps for prenatal health are you taking (nutrition, exercise, avoiding drugs, alcohol)?
Ashlyn: I take a prenatal vitamin daily, along with an anti-nausea medication because I was suffering from severe morning sickness. I should say that it was all day sickness, because I would get sick all day long. Whenever I tried to eat I would have to run to the bathroom. If I was able to keep my food down it wasn’t too long that I was heading to the bathroom again to get sick. I have used marijuana in the past, but have quit using. I have never have been fond of alcohol, so there is no need to worry about that. I try to walk every day, but lately I’ve been feeling very tired, it’s all I can do to stay awake.
6. What are your plans for the birth? Will the father be involved in the birth? In child care?
Ashlyn: I plan on trying for a natural birth, however if the pain is too much to handle I will ask for an epidural. I’m really scared that it is going to be too much pain to handle. So many people have told me that it is unbearable, but I guess I’ll just have to figure that out for myself. Obviously! My boyfriend does plan on being in the room with me and he is very excited. We talked and have decided that we’re not going to make a show out of it, by having everyone in there. It’s going to just be the two of us. He will also be very involved in helping me with the baby once he or she comes. He is so good with children, I watch him with his nieces and nephews and I just know that he will be a very good father.
PHYSICAL DOMAIN Ashlyn is 5’4” and weighs approximately 111 pounds. She has a mild heart murmur that requires no medication. Ashlyn has suffered from anorexia nervosa in the past, and her doctor is well aware of these medical issues, and is keeping a close eye on her. He explained to her that pregnant women with anorexia nervosa may have a higher risk of hypertension, miscarriage, difficult labor, premature delivery and intrauterine growth restriction. At the beginning of her pregnancy she weighed in at 107 pounds, but dropped down to 103 pounds, due to severe nausea and vomiting. Her doctor has prescribed an anti-nausea medication and the nausea/vomiting has ceased. Ashlyn’s doctor recommends that she gain anywhere from 25-35 pounds during her pregnancy. He also told Ashlyn that by the time she is 25 weeks pregnant he would like to see a weight gain of about 19 pounds. If she has not gained at least 19 pounds by that time they will explore some other options to improve her weight gain. According to the Body Mass Index (BMI) Ashlyn falls under a 19 weight range which indicates a normal weight for her height. So far Ashlyn is eating very well and gaining weight as her doctor has ordered. Since first interviewing Ashlyn she has entered her second trimester and has gained 4 pounds which is in the normal range of weight gain for the first trimester which is 1 to 5 pounds. Ashlyn took a stress test to see what her stress level would rate, and according to the Social Readjustment Rating Scale (SRRS) she scored a 193. The (SRRS) was created by Thomas Holmes & Richard Rahe, at the University of Washington’s School of Medicine to provide a standardized measure of stressors. This score would indicate a moderate stress level however this test is only an estimate. At her last prenatal appointment Ashyln talked to her doctor about stress, and he told her that moderate stress levels in pregnant women can do more good than harm to the unborn baby. Women with higher stress levels during their third trimester recorded faster movements of their babies in the womb and after birth. He also stated that one study states that moderate stress levels during pregnancy may actually enhance organ development before birth and help her baby later in future advancement. Further research on the effects of stress during pregnancy has shown stress can have some positive effects on the unborn child. Researchers from Johns Hopkins University in Baltimore and the National Institute of Child Health Development (NICHD) have found that mother’s who reported more stress during pregnancy did in fact have children with advanced mental and motor development by the age of 2 years. An explanation for this would be due to the level of the stress hormone cortisol. Women with higher levels of stress create more cortisol. It is believed that the cortisol is enhancing the development of organs before birth. Cognitive Domain Ashlyn is a student at the local community college, and maintains a GPA of 3.75. This is her last quarter at the community college. After she graduates she plans on transferring to a four year college to finish out her degree in Human Services. Ashlyn has struggled in a few subjects, like math, but has done exceedingly well. Ashlyn agreed to take an IQ quiz, a career aptitude test, a memory test, which is a variant of the classical Stroop test, and a reaction time test. The IQ test asked questions in verbal skills, mathematics, spatial, logic, pattern recognition, general knowledge, short term memory, visualization, and classification. Ashlyn scored 110 out of a greater than144 range. She scored highest in general knowledge, and lowest in mathematics. She is considered to be higher average. The career aptitude test results stated that Ashlyn would do best in psychology or counseling. Next Ashlyn took the Stroop test. The Stroop test was developed by John Ridley Stroop in 1935. The purpose of the thistest is to measure attention and executive function. The ability to sort out distracting information from meaningful information is an important part of our cognitive abilities, because much of the information we perceive isn’t relevant to the tasks that demand our attention at any given moment. This test showed that Ashlyn’s reaction time for the second test was a little over twice as long than the first test. When the meaning of the word and its color were congruent, such as the world “Green” written in green it was easier to recognize than the actual color of the word. However, when the meaning of the word was incongruent with the color, such as “Green” written in red color, it created a conflict between the color and the word’s meaning. The conflict was between the two brain processes of word and color recognition. The recognition required extra processing time in the second test. The reaction time test is an elapsed time between the presentation of a sensory stimulus such as visual or auditory and the human response. The reaction time is usually defined as the time required for the observer to detect the presence of a stimulus whether it be visual or audio. Ashlyn took a reaction time test that asked the participant to watch for the red dot to turn green. When the dot turned green Ashlyn would press a button which then recorded her reaction times. According to this test Ashlyn’s reaction time is in the normal range.
Psychosocial Domain Ashlyn and her boyfriend have been together for about 2 years. Before getting into a relationship with him she often felt lonely and depressed. After figuring out who she was she was finally able to be in a successful relationship. Today she is very happy with who she is, and the way that life has turned out. She has such a wonderful personality, and is a joy to be around. Ashlyn and her boyfriend have recently started talking about marriage and moving out on their own, but want to wait until after the baby comes. Ashlyn took a personality quiz developed by Carl Jung and Isabel Briggs Myers. The results from this test state that Ashlyn has an Extraverted iNtuitive Feeling Judging (ENFJ) personality. This type of person can see the big picture, and they are able to juggle an amazing amount of responsibilities simultaneously. They also have a tremendous entrepreneurial ability. They are charismatic and have an ability to manipulate others with their interpersonal skills. However this is not meant to be manipulative. Individuals with an ENFJ personality believe in their dreams, and see themselves as helpers and enablers. ENFJs like Ashlyn tend to put others needs before their own, and tend to take on the burdens of others and at times it’s more than they can bear. ENFJ personalities get lots of self-satisfaction through giving and helping others. They tend to do well at tasks that involve creating and maintaining order and structure, and are happiest when serving others. There are many career paths that are right for the person with an ENFJ personality some of them are nursing, teaching, child care, social work, and counselor. Ashlyn’s career choice as a counselor is a terrific choice.

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