wk 3 discussion

  • Complete all the requirements of the case scenario.
  • Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.

Case

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Scenario

1

Table 1

Standard level of HCG during pregnancy.

GA weeks

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HCG level

3 weeks LMP

4 weeks LMP

5 weeks LMP

6 weeks LMP

7-8 weeks LMP

9-12 weeks LMP

13-16 weeks LMP

17-24 weeks LMP

25-40 weeks LMP

Non pregnant

Table 2

Scenario

A normal ongoing pregnancy, the expectation for the beta HCG level is to _____ (hint: increase by how much) within 48-72 hours

During a spontaneous abortion (miscarriage), the expectation for the beta HCG level is to ____ (hint: decrease by how much) within 48-72 hour

During an ectopic pregnancy, the expectation for the beta HCG level is to ____ within 48-72 hour

During a gestational trophoblastic pregnancy, the expectation for the beta HCG level is to ____ within 48-72 hour

Table 3

Common complaints during pregnancy.

Keep in mind these symptoms are during pregnancy, make sure the cause, presentation, and treatment is related to pregnancy status of the patient.

Education

FatigueUrinary frequency

Definition and Cause

Presentation (include possible DDX)

Treatment

Constipation

Back pain

GERD

Heart palpitations

Nausea and Vomiting

Round ligament pain

Hyperpigmentation

Sleep disturbance

Tonia is an 18-year-old female who presents to your office complaining of two months of amenorrhea. Her pregnancy test is positive and her LMP indicates she is 5.6 weeks EGA. She reports she has had some bleeding for the past 3 days, that started as spotting, but has continued to be a light period- like bleeding today. She denies any pain. She indicates plans to continue the pregnancy.

  • Subjective: What other relevant questions should you ask regarding the HPI? What other medical history questions should you ask? What other social history questions should you ask?
  • Objective: Describe all elements of the head-to-toe assessment you will perform for her initial prenatal visitExplain what test(s) you will order and perform, and discuss your rationale for ordering and performing each test.
  • Assessment/ Diagnosis: What are your presumptive and differential diagnoses, and why?Any other diagnosis or differential diagnosis you would like to add?Assume you ordered an HCG today and the result was 1200. She returns to the clinic in 2 days and her HCG results is 550. What would be her diagnosis?
  • Plan: How will you explain the HCG results to your patient? Explain treatment guidelines and side effects including any possible side effects of the medication and treatment(s), partner notification, and follow-up plan of care.What patient education is important to include for this patient? (Consider when can the patient resume sexual activity, birth control options, when she can resume trying to conceive again).

Provide evidence from the research to support your decision-making.

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