Ms. X is a 34 year old female. The patient is a G3 P2, with both children delivered by C-section, with the only complication in both being low birth weights. Ms. X has a longstanding history of hypertension, anxiety and depression. Additional health history includes a vitamin D deficiency, back surgery in 05/06 due to a herniated disc, and two previous cesarean sections.…
* A 32-year-old pregnant woman comes into your Urgent care department. She is experiencing increased fatigue, dizziness, dehydration, and vaginal bleeding.…
1.How should the nurse record Amanda's obstetrical history using the G-T-P-A-L designation? A) 3-2-0-1-3.INCORRECTThis does not reflect the client's obstetrical history. B) 3-1-1-1-2.INCORRECTThis does not reflect the client's obstetrical history. C) 4-1-1-1-3.CORRECTGravidity [G] is defined as the number of times pregnant, including the current pregnancy. Term [T] is defined as any birth after the end of the 37th week, and preterm [P] refers to any births between 20 and 37 weeks. Both term and preterm describe liveborn and stillborn infants. Abortion [A] is any fetal loss, whether spontaneous or elective, up to 20 weeks gestation. Living [L] refers to all children who are living at the time of the interview. Multiple fetuses such as twins, triplets, and beyond are treated as one pregnancy and one birth when recording the GTPAL. Amanda's GTPAL is 4 (pregnancies counting current one) - 1 (infant born at 39 weeks) - 1 (twins born at 35 weeks) - 1 (spontaneous abortion at 9 weeks) - 3 (each twin and the singleton, all living). D) 4-2-1-0-2.INCORRECTThis does not reflect the client's obstetrical history.The nurse notes that Amanda's fasting 1 hour glucose screening level, which was done 2 days previously, is 158 mg/dl.2.The nurse recognizes that what information in the client's history supports a diagnosis of gestational diabetes? A) Maternal great-aunt has insulin dependent (Type 1) diabetes.INCORRECTFamily history of diabetes is not considered a risk factor unless it is a first degree relative. B) Youngest child weighed 4300 grams at 39 weeks gestation.CORRECTBirth of an infant over 9 pounds (~ 4.1 kg or 4100 grams) is a risk factor for gestational diabetes. Other risk factors include maternal age older than 25, obesity, history of unexplained stillborn, family history of Type 1 diabetes in a first-degree relative, strong family history of Type 2 diabetes, and history of gestational diabetes in a previous pregnancy. Ethnic groups at increased risk include…
Thanks for participating in the week’s discussion. Truly we are left with a small information to solve a huge problem in case scenario #4. I must say in most cases, the challenges in the real word looks similar. Therefore, as an advanced nurse practitioners we should strive to obtain a thorough menstrual, medical, and family history to prevent misdiagnosis. Ideally, menarches start at age 12 years and four months, and secondary amenorrhea should be suspected from performing strenuous exercise (athlete’s amenorrhea), anorexia, bulimia, pituitary lesions, or hereditary conditions (Fenstermacher &Hudson, 2016). In addition, pregnancy should be ruled out although her sexual lifestyle was not documented, and no drug history. However, patient’s height…
Susannah to evaluate third. She is at risk for not meeting basic needs like food and fluid. Next I…
“A rose for Emily” is a short story about the last member of her family, and her very old father. The story was published in 1930, by a very well respected author, William Faulkner. When Emily’s father dies, she is completely heartbroken and denies that he is really dead.…
In order to protect the client's privacy, she will be named as Mrs. Z and all other names will be represented by a respective letter to maintain confidentiality. This encounter happened at the Jewish General Hospital's Women's Health Clinic. Mrs. Z is a 34 year old female from a Filipino ethnic background. She works as a housekeeper. Mrs. Z is pregnant with her 2nd child and her estimated date of confinement is November 21st 2015. The fetus is active at home. She currently has gestational diabetes (GD) which is being treated for by diet control and insulin, both Humulin R and Humulin N. Otherwise, no thyroid or blood pressure health issues have been reported. Her past medical history includes a history of hepatitis B positive in 2012. She does not smoke nor drink alcohol. Her first pregnancy did not include GD, the delivery was a spontaneous vaginal delivery with a moderate amount of blood loss. Her current situation is that she is married to Mr. X. They live together but having , within the past few days, been victim of spousal violence, police was involved and a restraining order has been placed against her husband.…
William Faulkner’s short story “A Rose for Emily” carries a theme represented by a dying breed of that era, while using symbolism to represent tragedy, loneliness and some form of pride, the story also shows how far one will go to have the approval of others and the pursuit of happiness.…
Emptiness is the feeling you get at 2 A.M when you look at your old Facebook photos, smiling at the old photos of yourself, and realize the people who made you smile, laugh, and giggle are no longer around. You look at these photos as a journey down memory lane but in reality deep down somewhere, you wish you could experience these moments just once more. There’s nothing wrong with having a glance at the past but substituting the past for the present and yearning for it is dangerous. The past has a captivating effect that makes us fall in love it because it helps ignite a sense of happiness and comfortability. You can see the idea of never wanting to let go of the past go in “A Rose for Emily” by William Faulkner. “A Rose…
Emily today is your birthday and you have been so excited and so have I because you are finally 14 and you are such an amazing person nothing seems to phase you and your one of the strongest people I know you are a perfect gf and you know how always fix things and you have made me so happy these three months gonna be four soon and honestly it feels like we have been together forever because of the way we are together we get along so well because we're also best friends and that's the most important thing and I couldn't have asked for a better girlfriend and best friend you mean the world to me and I don't know what I would do if you weren't born and I don't ever wanna imagine what it would be like if I didn't have you in my life because without…
The narrator provides that Miss Emily is crazy in an obscure way. First the smell in which we can see in page 284, "will you accuse a lady to her face of smelling bad?" Second, when she wanted arsenic in page 286, "I want arsenic." Thirdly, how she never leaves her house in page 288. Lastly, she is crazy because when the townspeople went inside Miss Emily's house they found Homer lying in a bed decaying and found out that Miss Emily was sleeping next it in page 289, "Then we noticed that in the second pillow… leaning forward, that faint… long strand of iron-gray hair." We can infer that the narrators are just telling the story out of their observation from a first person plural point of view. The narrator is however very…
inpatient room. She has a history of several medical issues, such as sickle cell anemia, diastolic…
The nurse recognizes that what information in the client's history supports a diagnosis of gestational diabetes?…
In the short story “A Rose for Emily”, the reader can conclude that Emily appears to have had schizophrenia by way she interacts in the town. Emily’s mental problems start to come to light to the reader when she begins having hallucinations. The reader gains further background and further sees mental instability in Emily right after her father dies. The town people also begin to see that there are mental issues with Emily, yet do not want to make it known to keep the integrity of the town. Emily’s inability to form age appropriate coping skills furthers the point of schizophrenia.…
In the short story “A Rose For Emily,” by William Faulkner, Miss Emily Grierson is a woman who grew up in a well-privileged and respected family from the South raised by a very strict father. In the story, the affects of the death of her father are revealed leading her to be unsocial and hardly ever seen in town until a Northern man, Homer Barron, comes into town. Emily and Homer have a romantic relationship that surprises everyone around town especially since her father would not approve of them type of man Homer is. Although Emily and Homer are romantically involved, both characters seem to be the complete opposite of one of another and the only similarity they have is being powerful.…