PATIENT INFORMATION Name: Mia Robinson Medical History: gest
PATIENT INFORMATION Name: Mia Robinson Medical History: gestational… PATIENT INFORMATION Name: Mia RobinsonMedical History: gestational hypertensionG/P: G2 P1 TPAL: 1001Age: 38OB History: one previous pregnancy; no complicationsGestational Age: 34 0/7 weeksAllergies:NKDAPrevious Surgery:Knee arthroscopy 15 yrs agoCurrent Pregnancy:Diagnosed with gestational hypertension at 22 weeks gestationFamily History: significant for HTN of both parents; mother had a strokeRace/Religion:African American / BaptistMedications:PNVBaby Aspirin 81mg PO dailyLabetalol 100mg PO twice dailyReason for Admission:PreeclampsiaSO: Tyler JohnsonPhysical Exam: 97.7-88-18BP 178/94mmHgDenies HA, visual disturbances, RUQ or epigastric painMembranes: intactChildren: son; age 11Psychosocial Issues: Recent move to area with new partner/FOBBirth Plan: noneHt: 65″Current Wt: 225#Current Infection: noneInfant Feeding:Plans to breastfeedPrepreg. Wt: 185# Prepreg. BMI: 31.1Education:High SchoolPrenatal Labs:ABO/Rh:A+HBSaG:negativeAdditional Information:Other Labs:3+ proteinuria via dipstick350mg protein via 24hr urineAST 40 U/LALT 28 U/LLDH 450 IU/LSerum creatinine 1.0 mg/dLPLT 300,000/uLOccupation:Sales clerkGBS:negativeHIV:negativePrenatal Care:No recent care due to moveRubella:immuneH&H:11/35.4 Mia Robinson is a 38-year old African American woman who recently transferred care to a new obstetric provider and presents at 34 0/7 weeks of gestation according to her LMP. This is her second pregnancy. She delivered a full-term son by vaginal birth 11 years ago and reported that her pregnancy was uncomplicated. She reports that this pregnancy she was started on “blood pressure medication” about 12 weeks ago because her provider at the time said her blood pressure was too high. She also started taking aspirin every day. She recently moved and had missed her last OB appointment and is now new to this OB practice. She denies smoking, alcohol use, and any illicit drug use. This pregnancy is with a new partner. She had a follow-up appointment today as her blood pressure was elevated at her first routine appointment yesterday (154/92 mmHg). Her blood pressure at today’s appointment was 178/94 mmHg. She had a 24-hour urine completed which revealed proteinuria. She is now being admitted for blood pressure control and further monitoring due to preeclampsia. SCENARIO PREP S Does the patient have any risk factors for preeclampia? If so, what factors? What diagnostic testing could be completed for fetal assessment in the mother with preeclampsia? Name and describe 2 different tests that would be useful. Explain what procedures and medications may be needed during the scenario with this patient? If you need to administer IV Magnesium Sulfate, how many ml/hr would be infused for (1) the bolus dose and (2) the maintenance infusion for the following prescription? Administer Magnesium Sulfate (MgSO4) 4 g bolus over 30 minutes followed by an infusion of 2 g/hr IV.Available is MgSO4 20 g per 500 mL bag for infusion. Answer: (1) _____________ mL/hr for bolus dose (2) _____________ mL/hr for maintenance infusion 5. Why is MgSO4 administered to preeclamptic patients and what are the safety considerations with this medication?Health Science Science Nursing NURSING 1234
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