What should the nurse consider given this patients history

Reference no: EM133310504

Case Study: You are a registered nurse (RN) working in a Women's Health Clinic. Mary Claxmas, 38 years old, presents to the prenatal clinic after missing her last 2 menstrual cycles. Her home pregnancy test was positive. An ultrasound at the clinic confirms pregnancy. Gestational age is calculated to be 10 weeks. An initial assessment of Ms. Johnson's medical and obstetrical history follows.

Obstetric/Gynecologic (OB/GYN) history (hx): Uncomplicated spontaneous vaginal delivery (SVD) at 38.2 weeks (5 years ago); Cesarean section (C/S) x 1 at 37.5 weeks for non-reassuring fetal heart tones (FHT) (3 years ago); abnormal Papanicolaou (PAP) smear x 1, + human papilloma virus (HPV), colposcopy within normal limits (WNL); Chlamydia with treatment (7 years ago)

Medical hx: Chronic hypertension (HTN) x 5 years; asthma à no intubations or hospitalizations; hx of breast biopsy, benign (2 years ago)

Allergies: Penicillin

¢Social hx:

(+) tobacco, "occasional" per patient (pt), <5 per/day currently, has smoked "off and on" for 15 years

(+) cocaine use, states she has not used any cocaine/drugs for > 1 year; (-) alcohol use

Abusive partner with first pregnancy, states she has a new partner x 4 years

Depression, currently not taking meds for treatment (tx)

Medications: Prenatal vitamins; Labetalol 200mg BID; Albuterol inhaler as needed (prn)

Family hx: Insulin-dependent diabetes mellitus (mother); HTN and heart disease (father); lung cancer (CA) (maternal grandmother, deceased)

Question 1 - What should the nurse consider given this patients history?

Initial Prenatal Visit

Vital Signs (VS):

Temp 98.10 F, RR 20, HR 86, BP 142/79

Question 2 - What Labs should we get and why? (Name three)

Question 3 - What assessments should we do?

Question 4 - What complications of pregnancy is she at higher risk for (Name two)

Question 5 - What teaching can we do for her today?

Reference no: EM133310504

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