Case Analysis Comprehensive Nursing Essay Example

Case Analysis Comprehensive Nursing Essay Example

Summary of the Case

In the Case Study, Dr. Ebbie spent most of her life pursuing an education passion of becoming an orthopedic surgeon. She delays and postpones her life to get a family and find a spouse. Dr. Ebbie managed to become a top-level orthopedic surgeon after a lot of sacrifices and hard work. Later, Dr. Ebbie meets the love of life, Bernie, in court for a short while and gets married. A few years later, Bernie wanted to have children. The couple had never been married before, and Dr. Ebbie was now 53 years old and was likely to develop a complication during childbearing. Dr. Ebbie had not passed menopause but understood the problems associated with maternal age and genetic conditions. However, Dr. Ebbie was physically fit and healthy. The paper examines the framework of critical ethical issues, facts, and moral reasoning within Dr. Ebbie’s case scenario.(Case Analysis Comprehensive Nursing Essay Example)

Case Analysis Comprehensive Nursing Essay Example

What is menopause? Can women normally have babies after this period?

            Menopause is the point at which menstrual cycles cease from the depletion of ovarian oocytes from aging. Menopause is evident after a woman goes for 12 months without experiencing menstrual periods. Typically, menopause is a natural biological process and happens in the late ’40s or ’50s. Frequently, women are likely to experience physical symptoms such as hot flashes, cold sweats, vaginal dryness, weight gain, and loss of breast fullness that may affect their sleep, emotional states and lower their energy levels. The effective treatments for the symptoms range from life adjustment to hormone therapy.(Case Analysis Comprehensive Nursing Essay Example)

As mentioned, women do not produce eggs after menopause and cannot get pregnant in the natural biological process. However, the women can get pregnant using a donor egg where an egg is harvested from younger women. In this case, women aged 53 years and above, like Dr. Ebbie, have immense risks during pregnancy and require quality health care and close monitoring. Subsequently, estrogen and progesterone hormones are primed, followed by the implant of the fertilized donated egg.(Case Analysis Comprehensive Nursing Essay Example)

Since Dr. Townsend had not passed through menopause, would you say that she probably was still fertile? How would you know for sure if you were her gynecologist?

            If Dr. Ebbie was in the perimenopause stage, she had the chance of conceiving. Perimenopause begins a few years before menopause when the ovaries gradually decrease the production of estrogen. In this case, perimenopause lasts until menopause where the ovaries cease producing eggs. During one to two years of the perimenopause period, estrogen levels fall rapidly in women.(Case Analysis Comprehensive Nursing Essay Example)

As Dr. Ebbies’s gynecologist, I will ask her about her symptoms, conduct diagnostic tests, and track the menstruation cycle. Notably, postmenopausal women are likely to go for 12 months without experiencing any period when not pregnant. As mentioned, the women are likely to experience physical symptoms such as hot flashes, irregular periods, cold sweats, vaginal dryness, weight gain, and loss of breast fullness. The symptoms may affect their sleep, emotional states and lower their energy levels (Biglia et al., 2017). Secondly, examining Dr. Ebbie’s vaginal pH will determine if she has reached menopause. Women gave a pH of 4.5 during productive years and a pH of around six postmenopausal. Notably, blood tests are crucial in determining estrogen and Follicle Stimulating Hormone levels. During menopause, estrogen levels decrease while FSH levels increase.(Case Analysis Comprehensive Nursing Essay Example)

Why are women more susceptible to producing babies with genetic disorders as they get older?

            Genetic disorders and congenital disabilities arise from a chromosomal abnormality if women’s or men’s eggs contain the wrong number of chromosomes. In this case, the crossover proteins help chromosomes sort out themselves to the required numbers. As women get old, the proteins that bind chromosomes together are degraded, causing potential errors during the chromosome binding process. Again, women’s eggs have depleted over time, and only a few good ones exist to choose from during reproduction.(Case Analysis Comprehensive Nursing Essay Example)

Are men’s sperm just as likely to carry mutations in advanced age as eggs? Why or why not?

Older man’s sperms are just as likely to have mutations as an older woman’s eggs. Most of these mutations are likely neutral concerning the 60 mutations children bear in their genetic sequence. Typically, deleterious mutations are likely to cause diseases. In this case, it is infrequent to find mutations that offer a selective advantage to an offspring. As such, mutations are high linked with diseases such as Autism, Down Syndrome, and Schizophrenia.(Case Analysis Comprehensive Nursing Essay Example)

What maternal age, in your opinion, is it NOT okay to give birth to a baby? At what paternal age is it NOT okay to become a new father?

In my opinion, deciding when men and women should engage in reproductions can be sensitive and irrational since people are different and should be allowed to do things when they are ready. For instance, Dr. Ebbie’s prioritized achieving her academic success before deciding to start a family. Like Dr.Ebbie, people should have an opportunity to choose their priorities in life. However, if one decides to give birth at an older age like Dr.Ebbie, they should be accountable for their risks. However, I believe 50 years should be the maximum years for both men and women to reproduce. In this case, men above 50 years are likely to have inferior genes from frequent mutations that increase with age. Most women above 50 years do not meet physical demands for labor, which may lead to delayed labor or a caesarian section that is risky at old age.(Case Analysis Comprehensive Nursing Essay Example)

What are the concerns of the couple at this point in their lives?

            As depicted from the case study, the couple is concerned about Dr. Ebbie’s age. Despite Dr. Ebbie not being menopause, she is 53 years. At 53 years old, the couple is concerned about the problems associated with maternal age concerning congenital disabilities and genetic mutations.  In this case, there is a high risk of developing birth and genetic conditions from genetic mutations that increase with age (Janeca et al., 2017). The genetic conditions associated with old age are Autism and Down Syndrome, while congenital disabilities entail spinal Bifida and hydrocephalous. Again, there are risks of developing gestational diabetes and pre-eclampsia at old age life-threatening conditions during pregnancy.(Case Analysis Comprehensive Nursing Essay Example)

Should medical doctors deny certain people the right to use reproductive technology? When should they?

            Assistive Reproductive technology offers old couples an opportunity to conceive. However, health care professionals encounter several medical complications and ethical challenges during the Assistive Reproductions process. For instance, doctors encounter ethical issues such as patients who want to use their sons as sperm donors, disputes over embryo disposition, morally irresponsible couples, and selection without associate medical conditions (Harrison et al., 2017). In this case, medical professionals should use their code of conduct to allow couples to use Reproductive Technology. Doctors should not allow anyone to use reproductive technology. As such, the couple should be accountable and responsible for choices. The doctor should explain the risk factors involved. However, doctors should deny couples the use of Reproductive technology if the risks outweigh the benefits, for instance, if the use of technology is likely to cause death.(Case Analysis Comprehensive Nursing Essay Example)

What hormones are responsible for maintaining a healthy uterine lining? What is the condition of a uterine lining that is ready for implantation?

            Several hormones play a significant role in pregnancy. Notably, the progesterone hormone from the ovaries and the placenta plays a vital role in thickening the uterine wall in preparation for the implantation of fertilized eggs (Kadogo et al., 2019). As such, the uterine wall has to be thickened through progesterone effects before the fertilized egg implants. During pregnancy, the ovaries produce estrogen hormone responsible for maintaining a healthy pregnancy. Again, the human placenta lactogen provided nutrition and stimulated the mammary glands to produce milk for breastfeeding. The human chorionic gonadotrophic hormone produced only during pregnancy by the placenta is responsible for nausea and vomiting. The oxytocin hormone stimulates labor in preparation for birth.(Case Analysis Comprehensive Nursing Essay Example)

Since many eggs are fertilized, some of the embryos implanted will not live. Would this be the same thing as abortion? Why or why not?

            The mentioned fact is not the same as abortion since embryos with multiple genetic abnormalities are destroyed after they are implanted. In this case, the abnormal embryos are not given time to mature. Normal embryos produce trypsin hormone that prepares the uterine wall for implantation and typical development. Also, abnormal embryos that appear normal during laboratory tests may have defects that cause their death instead of growing.(Case Analysis Comprehensive Nursing Essay Example)

Case Analysis Comprehensive Nursing Essay Example

What is the problem with multiple births on infants? What can be the problems for the mother?

            Multiple pregnancies pose high risks to infants and pregnant mothers. Similarly, multiple-birth infants are likely to have congenital diseases (present at birth). The complications entail neural tube defects such as spinal Bifida, cerebral palsy, gastrointestinal and heart conditions. For instance, spinal Bifida results from the failure of the neural tube closure that a tuft of hair can diagnose at the lower back or the exposure of spinal nerves or membranes during birth. Following are complications like infections, urine, fecal incontinence, and paralysis. Hydrocephalous also develops from impaired cerebrospinal fluid transport. Also, multiple births are likely to cause cerebral palsy that results from brain damage during birth. Similarly, pregnant mothers are likely to experience problems with multiple births. The problems are associated with delivery complications leading to breach representation, uterine atony, difficulty extraction, and unengaged vertex of twin B.(Case Analysis Comprehensive Nursing Essay Example)


Biglia, N., Cagnacci, A., Gambacciani, M., Lello, S., Maffei, S., & Nappi, R. E. (2017). Vasomotor symptoms in menopause: a biomarker of cardiovascular disease risk and other chronic diseases?. Climacteric20(4), 306-312.(Case Analysis Comprehensive Nursing Essay Example)

Harrison, B. J., Hilton, T. N., Rivière, R. N., Ferraro, Z. M., Deonandan, R., & Walker, M. C. (2017). Advanced maternal age: ethical and medical considerations for assisted reproductive technology. International journal of women’s health9, 561.(Case Analysis Comprehensive Nursing Essay Example)

Janecka, M., Mill, J., Basson, M. A., Goriely, A., Spiers, H., Reichenberg, A., … & Fernandes, C. (2017). Advanced paternal age effects in neurodevelopmental disorders—review of potential underlying mechanisms. Translational psychiatry7(1), e1019-e1019.(Case Analysis Comprehensive Nursing Essay Example)

Kodogo, V., Azibani, F., & Sliwa, K. (2019). Role of pregnancy hormones and hormonal interaction on the maternal cardiovascular system: a literature review. Clinical Research in Cardiology108(8), 831-846.(Case Analysis Comprehensive Nursing Essay Example)

Case Analysis Comprehensive Nursing Essay Example

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