| Course | NR 327 Maternal-Child Nursing |
|---|---|
| Week | 2 |
| Paper type | Antenatal assessment write-up |
| Length | About 1,100 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 327 Week 2
Antenatal Assessment Write-Up: A 29-Year-Old at 30 Weeks in Her Second Pregnancy, Each Finding Dated and Split Between Her and the Pregnancy
Student Name
College of Nursing, Chamberlain University
NR 327: Maternal-Child Nursing
Instructor Name
Month Day, Year
Antenatal Assessment Write-Up: A 29-Year-Old at 30 Weeks in Her Second Pregnancy, Each Finding Dated and Split Between Her and the Pregnancy
Pregnancy History
Ms. V. is 29, a pharmacy technician, seen at a routine prenatal visit at 30 weeks and 2 days by dates confirmed on a first-trimester ultrasound; identifying details have been changed. She is gravida 2, para 1: one previous pregnancy, a vaginal birth at 39 weeks three years ago of a boy weighing 4,050 grams, with a second-degree tear and no other complications. She has no ongoing medical conditions. Her blood type is O positive. Her one-hour glucose screen at 26 weeks was 118 mg/dL.
The history goes first because it changes how everything below is read. A second pregnancy after a large first baby means the fundal height and the baby's growth are watched with the first birth weight in mind, and a woman who has given birth before may feel movement earlier and labor may move faster, which shapes what she is taught about when to call.
Her Own Account
In her words: "The baby is kicking all the time, mostly at night when I lie down." She sleeps on her left side with a pillow between her knees and wakes two or three times a night to urinate. She has had heartburn after dinner most nights for three weeks and says it is "way worse than with my first." She has cramps in her calves most nights. Her appetite is good. She stopped taking her prenatal vitamin about two weeks ago because it made her heartburn worse, and she had not mentioned this until asked directly what she was still taking. She says her ankles are puffy by the end of her shift and are normal in the morning. She has no headaches, no changes in her vision, no bleeding and no fluid leaking.
One Entry, Two Halves
Each system in Table 1 carries the finding and, beside it, the adaptation expected at 30 weeks, so a reader can separate what belongs to Ms. V. from what belongs to the pregnancy.
Table 1
Systems Findings at 30 Weeks, With the Adaptation Expected at This Stage
| System | Finding today | Expected at 30 weeks? |
|---|---|---|
| Cardiovascular | Pulse 92, regular; blood pressure 112/68 seated (first visit 114/72); soft flow murmur at the left sternal edge | Yes. Cardiac output rises by about 40% and heart rate by 10 to 20 beats a minute; pressure returns toward its baseline in the third trimester |
| Respiratory | Rate 16; saturation 98%; clear lungs; mild breathlessness climbing stairs | Yes, at a normal rate and saturation |
| Hematologic | Hemoglobin 10.9 g/dL at 28 weeks (12.8 at booking); MCV 86 fL | Partly. Plasma rises more than red cells, so hemoglobin falls; an unchanged MCV fits dilution, but she has stopped her vitamin |
| Gastrointestinal | Heartburn after evening meals; bowels every one to two days | Yes. Lower esophageal sphincter tone falls and the uterus displaces the stomach |
| Urinary | Frequency at night; no burning; urine dipstick negative for protein and nitrites | Yes, frequency; a negative dipstick excludes nothing serious but is reassuring |
| Musculoskeletal | Calf cramps at night; no calf swelling, redness or tenderness; mild lower back ache | Yes, cramps are common; one-sided calf swelling would not be |
| Skin and extremities | Ankle edema 1+ bilaterally, pitting; hands and face without swelling | Yes, dependent ankle swelling by evening |
Note. Expected changes are those described by Soma-Pillay et al. (2016). Hemoglobin was drawn at the 28-week visit.
Only one line in the table is not fully explained by pregnancy. Her hemoglobin has fallen by 1.9 g/dL since booking. Soma-Pillay et al. (2016) describe plasma volume rising by about 50%, mostly by 34 weeks, more than the red cell mass, with the mean cell volume usually unchanged. Her MCV of 86 fits that, and a hemoglobin of 10.9 would often be read as dilution. But she stopped her iron-containing vitamin two weeks ago, and the value was drawn before that. The finding is therefore not placed on a problem list, but it is not ignored either: it goes into the first nursing statement below.
The Uterus and the Baby
Fundal height today is 32 centimeters, taken symphysis to fundus with a paper tape and the numbers face down, against 28 centimeters at 26 weeks and 3 days. The rise of 4 centimeters in just under four weeks is in keeping with steady growth. Papageorghiou et al. (2016) developed international fundal height standards from serial measurements in eight countries, and serial plotting matters more here than any single value: a measurement 2 centimeters above her weeks, in a woman whose first baby weighed over 4 kilograms, is worth plotting and watching rather than reacting to once. The baby is lying head down on palpation, with the back on the maternal left.
The baby appears twice, and the two kinds of evidence are kept apart. What she reports: frequent movements every day, strongest in the evening. What was found: a fetal heart rate of 142 beats a minute by handheld Doppler, heard over the left lower quadrant, with an audible rise during a kick.
Two Nursing Statements
For Ms. V.: Risk for iron deficiency related to stopping her prenatal vitamin because of heartburn, in the third trimester when iron demand is highest. Plan: discuss taking the vitamin at a different time of day, away from dinner and not lying down after it, and ask the provider whether a repeat blood count or a different iron preparation is wanted.
For the baby: Readiness for enhanced awareness of fetal movement, as Ms. V. already notices a daily pattern and can be taught to recognize a change from it. Plan: ask her to notice her baby's usual evening pattern and to call the same day if movements seem fewer or weaker than usual, without waiting to count.
What Would Bring Her Back Before the Next Visit
The following were given to her in her own words and she repeated them back:
"The baby is moving less than usual, or the kicks feel different."
"I have a headache that won't go away, or my vision goes blurry or I see spots."
"My face or hands get puffy, not just my ankles."
"Fluid is leaking, or I'm bleeding."
"I'm getting tightening more than four times in an hour."
"One calf is swollen, red or sore."
References
Papageorghiou, A. T., Ohuma, E. O., Gravett, M. G., Hirst, J., da Silveira, M. F., Lambert, A., Carvalho, M., Jaffer, Y. A., Altman, D. G., Noble, J. A., Bertino, E., Purwar, M., Pang, R., Cheikh Ismail, L., Victora, C., Bhutta, Z. A., Kennedy, S. H., & Villar, J. (2016). International standards for symphysis-fundal height based on serial measurements from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: Prospective cohort study in eight countries. BMJ, 355, Article i5662. https://doi.org/10.1136/bmj.i5662
Soma-Pillay, P., Nelson-Piercy, C., Tolppanen, H., & Mebazaa, A. (2016). Physiological changes in pregnancy. Cardiovascular Journal of Africa, 27(2), 89-94. https://doi.org/10.5830/CVJA-2016-021
Reading the NR 327 Week 2 instructions
The Week 2 assignment asks you to complete and document a prenatal assessment on a pregnant patient. Instructors generally want obstetric history, the patient's report, a systems assessment, fetal assessment, nursing diagnoses with a plan, patient teaching and scholarly support in APA. Put the history first because it shapes how every later finding is read. Keep the woman's account in her own words, including anything she has quietly changed. For each system, show the expected adaptation beside the finding so normal changes stay off the problem list. Separate what the mother reports about the baby from what you measured. Write one nursing statement for each patient. End with the reasons she should call before her next visit.
How the NR 327 Week 2 example is put together
The paper opens with Ms. V.'s gravida and para, the dating ultrasound and her first birth, and explains why a large first baby matters at this visit. Her account follows in quotation marks, covering night kicks, sleep, urination, heartburn after dinner and the stopped vitamin. Table 1 sets each system against Soma-Pillay and colleagues' expected changes, so a pulse of 92 and a flow murmur sit in the expected column. The text then explains why a 1.9 g/dL hemoglobin fall is not fully covered by plasma expansion. Fundal height of 32 centimeters is compared with the 26-week reading. Two nursing statements address iron deficiency risk and fetal movement awareness. Six warning signs close the paper, written as she would say them.
NR 327 Week 2 rubric: what full points look like
Antenatal assessment rubrics usually score the history, completeness of the systems assessment, accurate interpretation of findings, fetal assessment, nursing diagnoses and plan, teaching and APA. Interpretation earns the most points when each finding is labeled expected or unexpected for 30 weeks with a source, which Table 1 and the hemoglobin paragraph supply. History is credited for detail that changes interpretation, such as the first baby's weight. Fetal assessment scores when the mother's report and the measured heart rate are kept separate. The nursing diagnosis row is met by a statement tied to the stopped vitamin rather than a generic one. Teaching is credited when warning signs are specific and the patient repeated them back. Papageorghiou and colleagues and Soma-Pillay and colleagues cover the evidence row.
NR 327 Week 2 help: mistakes that cost points
The heaviest point loss on this write-up is writing normal adaptations into the problem list, such as a raised pulse, a dilutional fall in hemoglobin or evening ankle swelling. Another frequent problem is using nonpregnant reference ranges without saying so. Students also blend the mother's report of movement with the measured fetal heart rate, which hides where each piece of evidence came from. Generic diagnoses such as knowledge deficit, with no link to this patient, earn little. Missing the patient's own account often means missing the stopped vitamin or a similar detail. Change identifying details. Notes from your own prenatal visit can be sorted into the same two-column NR 327 layout by one of our nursing writers.
Get a NR 327 Week 2 example written to your instructions
Send the Week 2 template your classroom uses, plus how far along the woman in your case is, and a custom example is written inside that template and returned inside 24 to 48 hours. The first one is free. If your section grades a rationale beside the form, send that requirement too and it comes back with one attached.
More NR 327 papers and pre-licensure samples
- NR 327 Week 1: Normal Pregnancy Adaptation Post
- NR 327 Week 3: Patient Teaching Plan
- NR 327 Week 4: Labor Case Response
- NR 327 Week 5: Postpartum Assessment Write-up
- NR 327 Week 6: Newborn Transition Write-up
- NR 327 Week 7: Concept Map
- NR 327 Week 8: Family Care Plan
- NR 328 Week 2: Growth and Development Write-up
- NR 326 Week 2: Therapeutic Communication Exercise
- NR 341 Week 2: Priority-setting Case
- NR 325 Week 2: Postoperative Trend Case Analysis
NR 327 Week 2 questions, answered
How much pregnancy history is enough?
Enough that a reader can predict what ought to be normal today. That usually means the number of pregnancies and births, how the earlier ones ended, and anything from them that could return in this one. What is not wanted is a paragraph of narrative already sitting in the record from previous visits, which is the commonest way these documents get long without getting better.
Does the baby get its own assessment?
Inside the same document, yes, and with statements of its own. The data arrives from three places, what the woman feels, what the examiner finds and what growth shows over time, and keeping those distinct is worth doing because they can disagree with each other. Papers lose ground when the baby shows up as a heart rate in the middle of a form and is never seen again.
Where should the reference values come from?
A current obstetric source, quoted with the point in pregnancy attached to it. A figure lifted from an adult medical text is the quickest way to get an expected change marked as a problem. It cuts the other way too, where something that does deserve attention gets waved through because the adult range still covers it comfortably. Put the source next to the value it justifies.
Where can I find a free NR 327 Week 2 sample paper?
This page has the full Week 2 antenatal write-up for Ms. V. at 30 weeks, including the systems table, the hemoglobin discussion, both nursing statements, the warning signs and its references.
Which finding does the NR 327 Week 2 paper say pregnancy does not fully explain?
The 1.9 g/dL fall in hemoglobin since booking. Plasma expansion accounts for part of it, but her stopped prenatal vitamin raises the risk of iron deficiency, so the finding is flagged.