Harm reduction strategies

 

 

Jackie is a 31-year-old pregnant patient (2nd child, two different fathers) single mother of a 6-year-old who is coming for prenatal care since she suspects she is pregnant. She is no longer with the father of Robby, her firstborn. She indicates "pretty serious partying" with the likely father of the baby. By pretty serious partying she means 10-12 drinks per occasion, one to two times per week, plus intermittent methamphetamine use.

Which clinical information would be most critical for you to collect in the first visit?
What are the greatest risk factors for substance use disorder for this patient?
Which harm reduction strategies would you recommend?
Identify your city. Then refer this patient to three agencies near you that would support positive health outcomes for this patient.   (These agencies must not have been used in past discussion posts). What was your rationale for choosing these three agencies?

 

Sample Answer

 

 

 

 

 

 

 

 

This is a complex and high-risk presentation. My priority in the first visit would be to establish a trusting relationship with Jackie, conduct a thorough assessment, and ensure her safety and the potential safety of her unborn child.

 

Which clinical information would be most critical for you to collect in the first visit?

 

Confirmation of Pregnancy and Gestational Age:

Urine pregnancy test.

First-trimester ultrasound for confirmation, viability, and accurate dating. This is crucial for guiding subsequent care and understanding potential fetal exposure timing.

Detailed Substance Use History:

Current and Past Substance Use:

Confirm frequency, amount, and duration of alcohol and methamphetamine use.

Ask about any other substances (tobacco, cannabis, opioids, other stimulants, prescription misuse).

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