Reference no: EM133571600

CASE SCENARIO: Mia, a 33-year-old married Indigenous female is currently 21 weeks gestation with an obstetrical history of G3T1P0A1L1. She has a three-year-old son and suffered one miscarriage in 2015. She had gestational diabetes and postpartum depression with her son. Mia is a non-smoker and walks one to two times a week. Mia's pre-pregnancy BMI was 28 and she has gained 15 pounds so far in this pregnancy. Currently, Mia is suffering from fatigue, nausea, and vomiting - which are different symptoms from her first pregnancy. During her prenatal appointment, Mia asked many questions and communicated her obstetrical history and new symptoms without concern. She is receptive to patient teaching about best practices to maintain a healthy pregnancy. Mia has expressed some concern about ongoing nausea and vomiting with this pregnancy. When assessed, she states it comes and goes for the most part of the morning and at times around dinner. She is not losing weight and is able to drink, but it still bothers her. Her current pregnancy has been confirmed by ultrasound and the fetal heart rate at this visit is 158bpm. She has had routine blood work such as CBC, type and screen, and an iron panel. Her type and screen results are AB negative. All other lab results are not yet available.

Questions: Please answer the following questions being sure to paraphrase your resources to show your understanding of your knowledge. Ensure proper citations are in each answer (answers with no citation will be graded "zero").

1. Discuss the three blood circulation shunts in a fetus before birth and the function of each shunt.

2. Describe the function of the four placental hormones.

3. Mia's last known menstrual period was April 23rd 2023. What is her Estimated Date of delivery (EDD)? Show your work.

4. Explain isoimmunization to Mia as it relates to her blood type using lay terms.

5. Identify the two priority timelines for medication intervention as it relates to Mia's blood type.

For questions 6 through 10:

Mia has brought up that she had gestational diabetes with her last pregnancy and wonders why she had it even though she has no history of diabetes. She is worried she will also get it with this pregnancy.

6. Briefly summarize two effects of pregnancy on glucose metabolism.

7. Given Mia's history, explain two reasons why Mia may be at increased risk of developing gestational diabetes mellitus.

8. Rank and discuss three medical interventions for gestational diabetes mellitus from least invasive to most invasive. Provide rationale for each.

9. Being mindful to avoid medical jargon, explain to Mia (using your own words) two risks of uncontrolled gestational diabetes on Mia's health and include rationale

10. Being mindful to avoid medical jargon, explain to Mia (using your own words) two risks of uncontrolled gestational diabetes on the health of her baby and include rationale