Question

case study

Annie, a new client, presents for an initial prenatal appointment to your office. She says she thinks she is pregnant because she took a home urine pregnancy test, and it read positive. Her menses typically comes once a month and she was a full month past her anticipated menstrual flow at that time of the test. She states that she is always nauseated in the morning and although she is sleeping well, she feels tired for the most of the day. She and her husband have not been using birth control and have wanted to have children since they got married last summer. Annie also reports that her breasts seem tender, and she notices that her jeans fit tighter and she has been frequently getting up to go to the bathroom at night. (M1 Learning Outcomes 1 and 3)

Annie presumes she is pregnant. What subjective data supports this conclusion? (On the list that you compose, indicate with an asterick *, those signs that are presumptive signs.)

List other conditions could be the cause of Annie’s symptoms.

What signs confirm a probable pregnancy?

List three classifications of medications that are known to alter a UPT-urine pregnancy test)

How can a pregnancy be diagnosed as positive?

List the weight gain recommendations and nutritional needs of Annie and her baby.

Answer 1

1. Subjective data she took a home urine pregnancy test, and it read positive (probable sign). Her menses typically comes once a month and she was a full month past her anticipated menstrual flow at that time of the test*. She states that she is always nauseated *in the morning and although she is sleeping well, she feels tired *for the most of the day and she reports that her breasts seem tender*, and she notices that her jeans fit tighter and she has been frequently getting up to go to the bathroom at night*.

presumptive signs are

• Amenorrhea (no period)
• Nausea
• Breast tenderness.
• tiredness.
• urinary urgency

2. Premenstrual syndrome

psudocyesis

ovarian cancer

3. probable sign- positive UPT result.

4. Anti psychotic drugs, Anti convulsant drugs, diuretics, anti histamines, anti parkinsons drugs may alter the result of UPT.

5. To conform a women is pregnant compare signs and symptoms, positive UPT result and ultrasonography

6.

BMI	weight gain ( recommended)
20-26 >29 <19	11- 16 kg </= 7 kg up to 18 kg

Nutritional requirements

energy- 2500 kcal

protein- 60 gms

iron- 40mg

calcium- 1000mg

folic acid- 400mcg

Iron may be negative balance in pregnancy. So supplementary iron recommendation is necessary.