N144 Week 2 Case Study - Susan Wilson (1) (ANSWERED) |Comprehensive Questions and with LATESt solutions (2024)| You work in an OB-GYN clinic. You greet Susan Wilson, a 26-year-old woman who has come to the clinic for her first prenatal visit. Three days
N144 Week 2 Case Study - Susan Wilson (1) (ANSWERED) |Comprehensive Questions and with LATESt solutions (2024)1. Your first answer is the one that counts towards your score, but you’ll be prompted to try again if you get the wrong answer. When you get the right answer, you’ll go to the next section. 2. If you choose to re-take a Patient Review, you will no longer be able to see your previous score.You work in an OB-GYN clinic. You greet Susan Wilson, a 26-year-old woman who has come to the clinic for her first prenatal visit. Three days ago, Susan performed a home pregnancy test that was positive. A serum pregnancy test done in the clinic lab yesterday was also positive for pregnancy. Susan's menstrual period is four weeks late and she reports having "symptoms of pregnancy." After reviewing the health history completed by Susan and checking her weight and vital signs, you enter data into her medical record. Susan's last menstrual period was two months ago. Her periods usually occur regularly every 28-30 days and last 5-7 days.You also review Susan's lab work, recalling that pregnancy tests on urine or blood are determined to be positive based on the presence of a particular hormone. This biologic marker of pregnancy is: human chorionic gonadotropin estrogen progesterone follicle-stimulating hormoneYou begin your interview with Susan. She is excited about being pregnant and eagerly tells you about herself. You ask Susan to describe how she has been feeling. Susan reports that she has been experiencing periods of nausea with occasional vomiting, particularly in the early morning. She also says that she is always tired and that her breasts feel heavier and are more sensitive than usual. And, she "can't seem to stay out of the bathroom." Urinary urgency and frequency, and nocturia, are common during early pregnancy. However, these symptoms also occur with urinary tract infections, which frequently occur during pregnancy. A clean-catch urine, for culture and sensitivity, will be obtained at this visit. This will verify the cause of Susan's complaints. You prepare Susan for a thorough physical exam, by having her empty her bladder. For her pelvic exam, you have Susan assume the lithotomy position. An alternative position is an exaggerated Sims position.During Susan's pelvic examination, a bluish discoloration of the cervix and vaginal mucosa is observed. This is a sign of pregnancy and is documented as ___________.Which of the following is considered a positive sign of pregnancy that could be present at this point in Susan's pregnancy (eight weeks gestation)? Fetal cardiac activity or body movement noted on ultrasound Palpation of fetal movements by an examiner Ballottement noted on vaginal examination Uterine souffle auscultated with DopplerSusan's physical examination is normal, and is consistent with a pregnancy of about eight weeks gestation. After some discussion with her care provider, you spend time counseling Susan regarding her pregnancy. Susan is anxious to know when her baby will be born. Susan's last menstrual period started March 7. You determine that her estimated date of birth is December 14. Using Nägele's rule, seven days are added to the first day of her last menstrual period, three months are subtracted, and a year is added. This calculation is based on a 28 day cycle; if menstrual cycles are longer or shorter, days are added to or subtracted from the estimated date of birth. A 24-hour diet recall reveals that Susan's diet is lacking in caloric intake, protein, and calcium, because of nausea and vomiting. Dietary modification is often helpful in alleviating or decreasing the nausea and vomiting associated with early pregnancy. In Susan's case, alleviating symptoms is especially important since the symptoms have affected her intake of important nutrients.Which of the following suggestions are appropriately made to Susan to help alleviate her symptoms? Select all that apply Eat a large breakfast Eat small frequent meals throughout the day Eat dry toast or crackers before getting out of bed Drink plenty of fluids when nausea occursVitamin B6 and/or ginger capsules are sometimes recommended when nausea is a problem. These dietary supplements have been found to be safe and effective for relief of nausea in pregnancy. Acupuncture and acupressure are effective non-pharmacological measures for relief of nausea. Beginning prenatal vitamins prior to conception (when a pregnancy is planned) may prevent the nausea and vomiting sometimes experienced during early pregnancy. You advise Susan that excessive vomiting should be brought to the attention of a health care provider immediately. Hyperemesis gravidarum, excessive vomiting, is a disorder of pregnancy that can cause dehydration. It should be reported and treated promptly.Susan asks you, "How much is too much vomiting?" You advise Susan to call the clinic if she experiences which of the following? Select all that apply She urinates less frequently than usual, and her urine becomes darker in color Her palms become reddened and itch She vomits blood or her throat becomes sore from vomiting She vomits everything she eats or drinks in a 24-hour periodIn formulating a plan of care based on Susan's symptoms of nausea and vomiting, which of the following is determined to be an appropriate nursing diagnosis? Risk for Injury related to malnutrition Imbalanced Nutrition: Less than Body Requirements related to nausea and vomiting Imbalanced Nutrition: Less than Body Requirements related to inadequate knowledge of good nutrition Deficient Fluid Volume related to nausea and vomitingYou continue counseling Susan about the nutritional aspects of pregnancy. Both the amount and pattern of weight gain during pregnancy are important. Based on determination of body mass index, Susan is considered to be of normal body weight for her height.You advise Susan that an appropriate weight gain during pregnancy based on her weight and height would be: 15 pounds (7 kg) 15 - 25 pounds (7 - 11.5 kg) 25 - 35 pounds (11.5 - 16 kg) 28 - 40 pounds (12.5 - 18 kg)Susan is curious about when she should gain all this weight. Your response is based on the concept that: primigravidas should gain two pounds (0.9 kg) per week throughout pregnancy most women gain more than half their weight by the end of the first trimester amount of weight gain is more critical than the pattern of weight gain 2-5 pounds (0.9 - 2.3 kg) should be gained in the first trimester, then an average of one pound per week thereafterSusan is curious about when she should gain all this weight. Your response is based on the concept that: primigravidas should gain two pounds (0.9 kg) per week throughout pregnancy most women gain more than half their weight by the end of the first trimester amount of weight gain is more critical than the pattern of weight gain 2-5 pounds (0.9 - 2.3 kg) should be gained in the first trimester, then an average of one pound per week thereafter
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susan is curious about when she should gain all th
