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Medical Conditions During Pregnancy

Medical Conditions During Pregnancy

Sample Answer 

Medical Conditions During Pregnancy

How Would You Document Her Obstetric History (GTPAL)?

G-6, T-3, P-1, A-1, L-3

What Is the Diagnosis and on What Criteria Can This Be Made?

The patient has Gestational diabetes mellitus (GDM). The normal blood sugar level should be equal to or less than 140mg/dl an hour after taking the glucose solution. The patient’s levels are 185 mg/l and 160mg/dl after a 2-hour period (Kamana, Shakya, & Zhang 2015).

What Are the Differential Medical Diagnoses?

  1. Insulin resistance
  2. Type I diabetes
  3. Type II diabetes

Discuss the Major Risk Factors for Your Diagnosis.

The main risk factors of GDM include previously having an unexplained stillbirth or miscarriage; having given birth to a baby that weighed at least 9 pounds or a baby who had a birth defect; being of American Indian, African, Hispanic, Asian, or Pacific Islander descent; being older than 25; being overweight, or gaining significant weight during pregnancy; high blood pressure, among others. The patient has had a miscarriage, is an Asian American, is 42 years of age, is obese with a BMI of 31, and has high BP.

What Is Your Treatment Plan for This Patient?

Koivusalo et al. (2016) state that patients should not be advised to lose weight during pregnancy. However, weight management goals will be set based on her weight before her pregnancy. The patient’s diet will comprise lean protein, whole grains, vegetables, and fruits, with limits on refined carbohydrates. Bain et al. (2015) note that regular physical activity will help lower the patient’s blood sugar and relieve common pregnancy discomforts such as muscle cramps, back pain, swelling, trouble sleeping, and constipation. The patient will aim for 30 minutes of moderate exercise to be done at least thrice weekly. The patient will also be required to check her blood sugar levels 4-5 times daily, immediately after she wakes up and after meals. Alfadhli (2015) adds that the patient may need insulin injections if diet and exercise are insufficient.

References

Alfadhli, E. M. (2015). Gestational diabetes mellitus. Saudi medical journal36(4), 399.

Bain, E., Crane, M., Tieu, J., Han, S., Crowther, C. A., & Middleton, P. (2015). Diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane database of systematic reviews, (4).

Kamana, K. C., Shakya, S., & Zhang, H. (2015). Gestational diabetes mellitus and macrosomia: a literature review. Annals of Nutrition and Metabolism66(Suppl. 2), 14-20.

Koivusalo, S. B., Rönö, K., Klemetti, M. M., Roine, R. P., Lindström, J., Erkkola, M., & Andersson, S. (2016). Gestational diabetes mellitus can be prevented by lifestyle intervention: the Finnish Gestational Diabetes Prevention Study (RADIEL): a randomized controlled trial. Diabetes care39(1), 24-30.

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Question 


Medical Conditions During Pregnancy

Discussion Topic 9 (Medical Condition During Pregnancy)

***The initial discussion response should be in the range of 250-300 words. All questions in the topic must be addressed. All discussions need to be supported by a minimum of two scholarly resource. Journals and websites must be cited appropriately (Citation and reference must adhere to APA format). All components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Case Study:

A woman presents to discuss the result of her glucose tolerance test. She is 42 years old and this is her sixth pregnancy. She has previously had three C-sections, one early miscarriage, and a termination of pregnancy. All previous diagnostic tests were normal as were her 11-14 week and anomaly ultrasound scans.
The woman is of Indian ethnic origin but was born and has always lived in the U.S. She is now 26 weeks gestation and a glucose tolerance test has been ordered.

Medical Conditions During Pregnancy

Medical Conditions During Pregnancy

Examination

  • The body mass index (BMI) is 31. Blood pressure is 146/87. The fundal height is 29 cm and the fetal heart rate is normal on auscultation.
  • Urinalysis: 1+ glycosuria
  • Glucose tolerance test (glucose drink): 185 mg/dL
  • 2 hour glucose tolerance test: 160 mg/dL

Questions:

  1. How would you document her obstetric history (GTPAL)?
  2. What is the diagnosis and on what criteria can this be made?
  3. What are the differential medical diagnoses?
  4. Discuss the major risk factors for your diagnosis?
  5. What is your treatment plan for this patient?

Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with citations and references in APA format.

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