Pharmacology, Medication, and Screening for Midwives

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Pharmacology, Medication, and Screening for Midwives
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Pharmacology, Medication, and Screening for Midwives
Professional Consultation and Referral Recommendations
Midwives are the primary caregivers to expectant mothers and they should, therefore,
make informed decisions regarding the need of medical attention for a woman under their care
during both prenatal and postnatal periods. The actions of these midwives are guided by The
Australian College of Midwives National Midwifery Guidelines for Consultation and Referral
(Syrio.org, 2018). These guidelines aim at promoting patient care related to the principle of
mutual cooperation between the maternity caregivers and the expectant woman in question.
Additionally, the guidelines have been developed with the intention of facilitating the integration
of care and consultation between midwives and the assigned doctors thus fostering confidence in
the involved women and their families (Syrio.org, 2018).
From the presented scenario, we are informed that Prue has a body mass index of
27kg/m2 and is also rubella immune. Additionally, she has been allergic to penicillin since
childhood and is potentially suffering from a urinary tract infection. In the guidelines developed
by the Australian College of Midwives, UTI is classified with a code B. From the assessment of
Prue’s scenario, it is clear that she could be suffering from a urinary tract infection.
During the booking visit, it is important to discuss with the woman involved her needs.
This discussion helps in the provision of quality care and enhances patient safety. According to
the guidelines published by the Australian Medical College, all conditions with a code A require
discussion. This kind of discussion happens with a midwife or a medical practitioner after which
the midwife continues providing patient care (Beasley, Ford, Tracy & Welsh, 2012). Conditions
that are assigned code B require consultations with a medical practitioner. Care may then

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continue with the midwife or the woman may be transferred to the involved practitioner. Finally,
the conditions assigned code C requires that the patient seeks a referral where the care is referred
to a medical practitioner.
Prue’s condition is defined under code B and therefore it may only require consultations.
The midwife in charge, therefore, needs to seek consultation with a medical practitioner. The
midwife must seek the consent of Prue before initiating the process of consultation where she
clearly has to communicate with the practitioner that she is seeking consultation (Beasley et al.,
2012). She is then tasked with communicating all her findings to Prue and the health practitioner
involved.
During consultations, Prue must be involved in all decision-making processes concerning
her care. Automatic assumption of the responsibilities by the midwife or the healthcare provider
regarding the ongoing care may depend on the clinical situation and the needs and preferences of
Prue. At the end of consultations, a decision is made whether care remains with the midwife or is
transferred to the health practitioner (Beasley et al., 2012). The midwife, however, continues to
provide care within her scope of practice. Further consultations may be made to ensure that Prue
and her unborn child receive high standards of care and thus prevent potential early
complications.
Administration of Medication
Urinary tract infection is an infection caused by an attack of any part of the urinary
system such as the kidney, bladder, and urethra by bacteria (Foxman, 2013). Most infection of
the urinary tract involves the bladder and the urethra. Antibiotics can, however, be used to treat
urinary tract infection (Sheerin, 2011). One of the widely recommended antibiotics for UTI is

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cephalexin. It is a first-generation cephalosporin antibiotic that is very effective against several
gram-positive bacteria (Vazquez & Abalos, 2011). This is the best form of medication for Prue
given that she is allergic to penicillin. Cephalexin binds with specific proteins found within the
bacterial cell walls thus inhibiting the final stage of bacterial cell wall synthesis (Dason, Dason,
& Kapoor, 2011).
Prue should take cephalexin orally after every twelve hours either with or without food.
Strict adherence to the dosage is important for best medical results. I would additionally advise
Prue to take this medication at evenly spaced times. This can be done by taking the medication at
the same times on a daily basis until the prescription is over (Barber, Norton, Spivak & Mulvey,
2013). Prue must not stop taking the drug even if signs of her condition disappear; she has to
complete the full dosage of the medicine. This is so because stopping the medication before
completion may cause the bacteria to keep growing and cause a recurrence of the infection
(Fanun, Papadimitriou & Xenakis, 2011). It is also important that I inform Prue that the capsules
must not be chewed or crushed but be taken a whole with a glass of water. Hand hygiene is
another very important factor when handling any form of medication (Epp et al., 2010). Prue
must ensure that her hands are clean at all times to avoid contaminating the drug.
It is also advisable that Prue is informed of cephalexin’s interaction with other forms of
medication. She, therefore, needs to inform the doctor if she is using any other prescriptions
including over the counter drugs, herbal medicine, and dietary supplements (Cunha, 2010). It is
important to note that the interaction of cephalexin with other drugs such as metformin and
probenecid and cause problems.