Reference no: EM133469030
Questions
1. Explore and define the following signs of pregnancy. Please include at least 2 examples for each.
a. Presumptive signs of pregnancy
b. Probable signs of pregnancy
c. Positive signs of pregnancy.
2. Upon pregnancy confirmation, what are 3 essential items that MUST be addressed to the pregnant patient (regardless of practice setting)?
3. During pregnancy there are several physiologic adaptations. Please find and explore cervical physiologic adaptations that occur during pregnancy. Describe and define each of the 3 cervical physiologic adaptations and when or how the adaptations can be appreciated during a physical exam.
4. During pregnancy there are changes in blood pressure. Please explore how blood pressure changes throughout the pregnancy and explore and discuss the cause for the changes.
5. Musculoskeletal changes are common during pregnancy. Identify two hormones that affect the cartilage and connective tissue during pregnancy that can result in the loosening of the symphysis pubis and the sacroiliac joint, but also increase the susceptibility of joint sprains and waddling characteristic of pregnancy.
6. Name two vaccines that are recommended in pregnancy. Describe and discuss the timing during gestation for the administration of each of the vaccines. Name two (common) vaccines that are contraindicated during pregnancy and discuss the rationale for the contraindication. If it is identified that a pregnant individual should receive the contraindicated vaccines, when should the vaccines be administered?
7. Explore 3 dietary or environmental substances that should be avoided during pregnancy. Address the places/ locations that a pregnant individual might be exposed to the toxic substances and what may result secondary to exposure.
8. Preconception care is often underutilized in our health care system. How would you care for the following patient? A 27- year-old G0 female presents to your office for a refill on her antihypertensive medication. Her blood pressure is well controlled with losartan 50 mg PO QD and she denies side effects (she has been taking this medication and dose for 1.5 years). During your conversation with the patient, you discover that she is sexually active and is not currently trying to prevent pregnancy. What would you include in your history taking, your physical exam, assessment, and plan?
9. A 25-year-old G2P1001 pregnant patient at 30+2 weeks presents to your office complaining of nasal congestion, post-nasal drip, and sore throat x 3 days. She has not taken any OTC medications. Physical exam reveals positive bilateral mild maxillary sinus pressure with palpation, slightly dull bilateral tympanic membranes, bilateral boggy turbinates, cobble stoning in the posterior pharynx, 1+ tonsils, no tonsillar exudate, no cervical lymphadenopathy. The rapid test for strep is negative.
What would you include in your plan of care for this patient (diagnostics, interventions, medications, follow up care, etc.)?
10. A 33-year-old G4P2103 pregnant woman presents to your office at 28+4 weeks complaining of low back pain for the last day. She has not tried any OTC treatments. She rates her pain as fairly constant 3-4/10 but occasionally the pain increases to intermittent pain 6-7/10. What additional information would you want to gain from the patient? What are the 2 differential diagnoses you are considering based on the information provided? What would you include in your plan for both of the differential diagnoses?