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CASE SCENARIO: Julia, a 30-year-old married Indigenous female is currently 23 weeks gestation with an obstetrical history of G3T1P0A1L1. She has a three-year-old daughter (born 2021) and suffered one miscarriage in 2015. She had gestational diabetes and postpartum depression with her previous pregnancy. Julia is a non-smoker and walks one to two times a week. Julia's pre-pregnancy BMI was 32 kg/m2 and she has gained 18 pounds so far in this pregnancy. Currently, Julia is suffering from fatigue, nausea, and vomiting - which are different symptoms from her first pregnancy. During her prenatal appointment, Julia 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. Julia has expressed some concern about her continued nausea and vomiting with this pregnancy. When assessed, she states it is present most days, for the majority of the day. It is worst in the morning and at bedtime. She is not losing weight and is able to drink, but it still bothers her and is beginning to affect her negatively. Her current pregnancy has been confirmed by ultrasound and the fetal heart rate at this visit is 160bpm.
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