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Audio Recording Oct 2, 2022 at 8:50:00 PM. 714960A5-0203-4964-BC27-A256A0D71D2C_dBP7wp.mp4.
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28662FAF-1EAB-46F5-B826-936CF5F21916_yyy8Vy.mp4. History of Present Illness:.
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07D47E29-09E8-4421-AAB3-44A1EC8164EE_Uz4dii.mp4. Allergies: NKA Medication: prenatal vitamins- generic Immunizations: Tdap vaccine last visit Gynecology History: G3P0, 2 SAB’s 2019, 2020. LMP unknown. IVF transfer Feb 5, 2022. EDD 10/18, 2022. Menarche at 14 years old Sexually active: Yes, with men, married for 6 years, and her only partner is her husband Denies any pain during intercourse. No history of sexual, physical, or mental abuse. Social History: Denies any drinking, smoking of illegal drug use while pregnant. Past alcohol use, socially 1-2 glasses a month, never smoker, never used any illegal substances, never vape, no marijuana use. Denies any STDs in the past Past Medical History: No known past medical history. Surgical history: none Family History: Mother is alive, hypertension, hyperlipidemia. Father alive, prostate problems Patient has 1sisters, alive and healthy. Exercise practices: irregular, used to go to the gym 2-3 times a week Dietary practices: no special dietary practices She works full time in accounting. Married..
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1AFDE9F9-761A-49DB-8744-D7A4D693BA50_WzeBTj.mp4. ROS.
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FBE04775-0ADC-4199-B0BE-6A36BF546A1B_XeCuAz.mp4. PHYSICAL EXAM.
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D99E78D3-41A4-4E3E-9347-8C6F9E55D78A_i8zOWZ.mp4. General: patients alert and oriented x 4, no evidence of acute distress HEENT: eyes WML, white sclera, no drainage, red reflex present, pupils round, equal, and reactive to light and accommodation, ears show no infections, no drainage, tympanic membrane gray, skin intact, warm, and dry Neck: no palpable lymph nodes, no difficulty swallowing, no bruits Lungs: clear in all lobes, no cough Cardiovascular: regular, no murmur Abdomen: soft, gravid, non – tender, normal bowel sounds Musculoskeletal: ROM intact Extremities: equal and steady gait, lower extremities show bilateral pedal edema that is non pitting, no clonus, reflexes in lower extremities +2 Genitourinary: no bleeding or discharge noted Psychological: denies.
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1998ED2D-B02A-4B1F-B533-A255B929214D_I9hXK3.mp4. Labs:.
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8CFDF2EB-D062-4912-86E2-0E928A509F2A_UH9Sxs.mp4. Assessment:.
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74CAA02A-61B5-4468-96E4-304A79A4943B_RmYLLD.mp4. Plan:.
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1F661854-A4E4-427F-8A8F-DC84AEF98050_P7O9Ku.mp4. Education:.
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IMG_1673_OYTIdu.mp4. There are different types of hypertensions: Chronic Gestational pre-eclampsia.
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IMG_1674_ArBu9k.mp4. Risk factors:. -first pregnancy -having hypertension before pregnancy (chronic) -having hypertension with previous pregnancy (August & Sibai , 2021). -being over 35 years old (August & Sibai , 2021). -having multiple gestation (August & Sibai , 2021). -being a diabetic or having kidney problems -being African American (August & Sibai , 2021). -obesity -having immune conditions or blood disorders (August & Sibai , 2021)..
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IMG_1675_R5ON8P.mp4. Chronic or gestation hypertension do not cause major problems pre-eclampsia does. Blood pressure of 160 systolic and 110 diastolic is a sign of sever pre-eclampsia..
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Symptoms of pre-eclampsia:. increased protein in your urine -swelling in hands and knees -headaches (August & Sibai , 2021). -dizziness (August & Sibai , 2021). -sudden weight gain ( Norwitz , 2022). -slurred speech -visual changes ( Norwitz , 2022). -light sensitivity -abdominal pain, especially in upper right area, vomiting -shortness of breath ( Norwitz , 2022). -increased reflexes ( Sibai , 2022). -numbness in hands and feet ( Norwitz , 2022)..
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C15B81CB-EC96-47CC-93DB-150F2C47A6E0_AlmKf7.mp4. HELLP syndrome = severe pre-eclampsia Anemia high liver enzymes low platelets It often has no warning symptoms, and it can be deadly to mother and fetus ( Sibai , 2022)..
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IMG_1677_85ebaF.mp4. GBS swab. Bacteria in rectal and vaginal area does not cause symptoms in those women it increases risk for passing these bacteria to the baby during birth GBS can cause fever, difficulty feeding, difficulty breathing, and sepsis. If a woman is found to be positive for GBS, she is treated with antibiotics during labor (Puopolo & Madoff, 2022)..
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3F557D95-1592-4AD7-8DD0-9FD787012388_QIGz25.mp4. Fetal well – being:.
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E942A67C-F559-429B-8E16-004AAB789B09_YIvqQl.mp4. Home instructions.
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FA7D7D45-89C1-4503-99A7-51F42B43C4C5_jEUUq6.mp4. Medication:.
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76FDA860-A5E7-430B-8B0A-8F2BC6EE6D67. Seek medical care if.
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76FDA860-A5E7-430B-8B0A-8F2BC6EE6D67. Seek immediate medical attention if.
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FA7D7D45-89C1-4503-99A7-51F42B43C4C5_ucclnE.mp4. Follow up :.
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References. August, P. & Sibai , B., M. (2021). Hypertensive disorders in pregnancy: Approach to differential diagnosis. Up to Date. Retrieved on September 28, 2022 from https:// www.uptodate.com /contents/hypertensive-disorders-in-pregnancy-approach-to-differential-diagnosis?search=hypertension%20in%20pregnancy&source= search_result&selectedTitle =3~150&usage_type= default&display_rank =3 August, P. & Sibai , B. (2022). Preeclampsia: Clinical features and diagnosis . Up to Date. Retrieved on September 28, 2022 from https:// www.uptodate.com /contents/ preeclampsia-clinical-features-and-diagnosis?search = preeclampsia&source = search_result&selectedTitle =1~150&usage_type= default&display_rank =1.
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Melvin, L., M. & Funai , E., F. (2022). Gestational hypertension. Up to Date. Retrieved on September 28, 2022 from https:// www.uptodate.com /contents/ gestational-hypertension?search =hypertension%20in%20pregnancy&topicRef=126975&source= see_link Miller, D., A. (2022). Nonstress test and contraction stress test https:// www.uptodate.com /contents/ nonstress-test-and-contraction-stress-test?search = NST&source = search_result&selectedTitle =1~17&usage_type= default&display_rank =1 Norwitz , E., R. (2022). Preeclampsia: Antepartum management and timing of delivery. Up to Date. Retrieved on September 28, 2022 from https://www.uptodate.com/contents/preeclampsia-antepartum-management-and-timing-of-delivery?search=hypertension%20in%20pregnancy&topicRef=6805&source=see_link#H1783838804.
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Patient education: How to tell when labor starts: The Basics. (2022). . Up to Date. Retrieved on September 28, 2022 from https://www.uptodate.com/contents/how-to-tell-when-labor-starts-the-basics?search=labor%20precautions&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 Puopolo, K., M. & Madoff, L., C. (2022). Group B streptococcal infection in pregnant individuals. Up to Date. Retrieved on September 28, 2022 from https:// www.uptodate.com /contents/ group-b-streptococcal-infection-in-pregnant-individuals?search =gbs%20bacteriuria%20in%20pregnancy&source= search_result&selectedTitle =1~150&usage_type= default&display_rank =1 Sibai , B., M. (2022). HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets). Up to Date. Retrieved on September 28, 2022 from https:// www.uptodate.com /contents/hellp-syndrome-hemolysis-elevated-liver-enzymes-and-low-platelets?search=hypertension%20in%20pregnancy&topicRef=126975&source= see_link.