Case Study Question 3: 1045: The nurse practitioner (NP) reviews

Case Study Question 3: 1045: The nurse practitioner (NP) reviews the nurses’ notes and suspects the client is at 15 weeks gestation. Some tests are prescribed A urine sample is obtained and blood is drawn for an hCG (human chorionic gonadotropin) level, hemoglobin (Hgb), hematocrit (Hct), white blood cells (WBC), red blood cells (RBCs), fasting blood glucose, blood type and Rh status, and rubella and varicella antibody titers. Genetic carrier screening is done as well as screening for sexually transmitted infections (STIs) (hepatitis B, syphilis, gonorrhea, chlamydia, and HIV). An ultrasound is done and a pap smear is completed. Some tests were completed and results are as follows. Nurses’ Notes Vital Signs Lab Tests Diagnostic Tests 1000: VS: T 98.6.F (37.0.C), HR 88 BPM regular, RR 20 bpm, Spo2 95% RA, BP 142/92, mmHg, Pain 0/10 on 0 to 10 pain scale, Wt. 210 Jb (95.25 kq), BMI 31, Ht. 5 feet (152.4 cm) Assessment | NP Orders Lab Tests Diagnostic Test Social Behaviors: Denies smoking, alcohol use, or other substance use. Family History: Mother has diabetes type 2; no other familial medical history. Past Medical History: No major illnesses or surgeries. Gynecological History: Age 15 of first menstrual period; periods regular; denies history of abnormal Pap smears or sexually transmitted infections. Obstetric History: GTPAL: 3, 2, 0, 0, 1; has 3 year old child, term birth weight 7 lbs. (3.17 kg); one full-term unexplained stillbirth. Head/neck: Facial symmetry, purposeful neck and shoulder movements. EENT: Reports dry eyes. Ears, nose, throat: No redness or swelling noted. Gastrointestinal: Reports dry mouth and thirst. Is nauseated in the morning but no vomiting. Bowel sounds heard in all 4 quadrants. Had a BM today. Integumentary: Warm and dry, skin integrity intact, denies itching or sweating. Respiratory: Lungs sounds clear. Denies cough or shortness of breath. Cardiovascular: No cyanosis, capillary refill is 3 seconds. No edema. No tenderness in the lower extremities. No varicosities. Denies lightheadedness or weakness. Reports BP is chronically elevated and client has been trying to eliminate high salt foods and exercise regularly. Genitourinary: Reports increased voiding. No bladder distention. Musculoskeletal: Notweakness. Reports able to ambulate freely without restriction. Immunizations: Completed 2 doses of COVID vaccine 4 months ago; had influenza vaccine 3 months ago. Mental Health: No history of mental health disorders.

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