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Case Study: Nevaeh Teenage Pregnancy

The glandular structures found Nevaeh’s breast tissues play a vital function in reproduction. These tissues are responsible for the secretion of the lubricating fluid during sexual intercourse. During pregnancy however, the secretion of these tissues changes adversely for proper maintenance of the pregnancy especially during the first trimester. They enhance a supportive environment for the growth of the embryo. The duct system in breasts is stimulated to develop by the progesterone hormone. The glandular tissue aids in the production of breast milk during pregnancy. Hormones produced during pregnancy enhance the development of the breasts. The stimulation of these hormones during pregnancy will continue and result in the production of breast milk (Förnvik et al., 2018).

Oxytocin will be produced during lactation and help in contraction of the myoepithelial cells that surround the alveoli and the small interlobular ductules. This contraction will provoke the muscles around the breast to eject milk from the mammary gland. The ejected milk contains little amounts of oxytocin, although they do not have any negative impacts on the body. The amounts of oxytocin in breast milk will reduce gradually after birth and as the baby grows as indicated by Efimovich et al., (2019). The levels of oxytocin increase during pregnancy throughout all three trimesters. Oxytocin however, will be responsible for notification of contractions in the uterus during Nevaeh's labor. During post-pregnancy, the levels of oxytocin hormone produced in the body shall reduce gradually.

The kidney plays a vital role in maintaining fluid balance within the body. It helps to maintain concentrations of electrolytes in the body. This is done through filtration of water from the blood and excreting the excess water into the urine. The balancing of the fluids aids to control the cells from either getting or losing too much water. If the body loses or gains too much water, normal functioning will be impaired. The kidney receives a signal from the antidiuretic hormone located in the brain, on the amounts of water to be retained in the blood and the amounts to be released (Braam, 2019). When too much water is in the blood, there is a decrease in the release of the antidiuretic hormone that results in the excretion of more water through urine. The antidiuretic hormone helps to maintain blood pressure by balancing fluids in the body. Nevaeh is at risk of not maintaining her homeostatic fluid mechanism due to the poor diet she takes and the negative nitrite present in her body. The negative nitrites may result in poor functioning of the homeostatic fluid mechanism.

Urinalysis is a test carried out on the urine to detect the presence of diseases, disorders, or even drugs present in the body. Diseases like diabetes and urinary tract infections can be detected easily through a urinalysis test. For Nevaeh's case, a urinalysis was important as it helped in the detection of human chorionic gonadotropin which was an indication that she was pregnant. Besides, it also aided in the detection of high levels of sugar that may result in gestational diabetes during the 20th week. It as well helped in the assessment of the hydration state of the body and detect kidney infections if there were any. The excess protein component present in Nevaeh's urinalysis is not a good indication. This bases on the fact that excess proteins impair the kidney’s normal functioning. They may as well result in chronic kidney infections. (Free, 2018).

Gut motility is the stretching and contraction of muscles in the gastrointestinal tract. It aids in the proper movement of food through the intestinal tract. Nevaeh's gut motility has decreased during her pregnancy, evident by her poorly nourished body status. The synchronized contraction of the gastrointestinal muscles is called peristalsis. Dimidi (2017) argues that a poorly hydrated body may result in the food particles to the backlog and result in obstruction of the intestines.

She has to maintain adequate protein intake for the benefit of the developing fetus in her womb. Protein intake will aid her growing fetal body to repair the damaged tissues within itself and grow effectively. Adequate protein intake also increases the sufficient supply of blood to the fetus while stabilizing the growth of the brain. More so, the antibodies that ensure a stable immunity system as well develop through adequate intake of proteins during pregnancy. Fetal growth solely depends on the mother's dietary behaviors. The sufficient supply of a diet enriched with proteins ensures proper and healthy growth of the fetus.

The route of administration of the paracetamol drug taken by Nevaeh was an oral administration route. Absorption of most substances, inclusive of all medicines takes place in the small intestine. Regardless of the route and form of administration, all drugs must be in solution form to be absorbed (Ruiz and Montoto, 2018). The paracetamol drug passed through several cell membranes by passive transport before they were absorbed in the bloodstream. Due to the oral administration, the paracetamol concentration in the body would be at 79%. It may also vary as the large doses of the paracetamol may impose it on the hepatic first-pass effect which reduces due to the overwhelming of the liver enzymatic capacity and increases bioavailability.

The half-life of a drug is the amount of time taken for the plasma concentration of a drug to reduce to half its original value. The half-life of any drug is essential as it is the main determinant to the possible time that one is supposed to stop taking the drug. It as well as an indication of the time the drug effects are felt in an individual. During this time, possible effects may rise judgement of whether the drug is right or not. With the 100% absorption of the paracetamol and a half-life of 6 hours, 62.5% of the paracetamol will be present Nevaeh’s blood after 24 hours.

The mean arterial pressure varies during pregnancy depending on different individuals. The weight of the mother and chronic hypertension conditions are some of the dependent characteristics of the arterial pressure in different expectant mothers. Additionally, the vessels transporting blood increase as the body gains weight due to pregnancy. The increased vessel length will result in a decrease in the mean arterial pressure. The changes in the arterial blood pressure result in slowing down the progression of kidney disease. Increased pressure also leads to renal hypertension caused by kidney disease which may lead to kidney failure.

The renin-angiotensin-aldosterone system is a hormone that plays a vital role in the maintenance of blood pressure as highlighted by Cabandugama (2017). When blood volumes or sodium levels in the body are low or high, enzyme renin is released by the cells in the kidney that causes blood vessels to constrict and offer the relevant change in pressure. The hormone regulates the required blood pressure and aids in the balance of fluids in the body. The hypovolemia activates this hormone systematically to increase the blood pressure, stimulate drinking, and increase sodium reabsorption in the kidney tubules to restore the volume of blood.

References

Braam, B. (2019). “Overruled”: the kidneys’ judgment of sodium balance versus stabilization of renal function. American Journal of Physiology-Renal Physiology, 316(2), F221-F222.

Cabandugama, P. K., Gardner, M. J., & Sowers, J. R. (2017). The renin-angiotensin-aldosterone system in obesity and hypertension: roles in the cardiorenal metabolic syndrome. Medical Clinics, 101(1), 129-137.

Dimidi, E., Christodoulides, S., Scott, S. M., & Whelan, K. (2017). Mechanisms of action of probiotics and the gastrointestinal microbiota on gut motility and constipation. Advances in Nutrition, 8(3), 484-494.

Efimovich, D., Babaryko, D., Ruta-Zhukouskaia, E., & Syakhovich, V. (2019). Analysis of chemically modified hemoglobin using proteomic methods.

Förnvik, H., Timberg, P., Dustler, M., Förnvik, D., Zackrisson, S., & Tingberg, A. (2018, March). Towards determination of individual glandular dose. In Medical Imaging 2018: Physics of Medical Imaging (Vol. 10573, p. 1057304). International Society for Optics and Photonics.

Free, H. M. (2018). Urinalysis in clinical laboratory practice. CRC Press.

Ruiz, M. E., & Montoto, S. S. (2018). Routes of Drug Administration. In ADME Processes in Pharmaceutical Sciences (pp. 97-133). Springer, Cham.

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