Epigastric Pain Case Study

It is our pleasure to see and perform FTS on Ms. Kaylyn Houser. She is a 16yo, G1 P0, with EDD by LMP consistent with an 8-week 4-day ultrasound performed in your office. The patient has a history of anxiety and what sounds like bipolar disorder, narcolepsy, and sleep apnea, as well as prepregnancy BMI of 32. She was previously on Lamictal, Luvox, and magnesium when she started the pregnancy and comes today attempting to wean from the Lamictal currently taking 100 mg daily. Her surgical history is notable for ankle surgeries. She has no prior pregnancy history. Her social history is negative x3. Her registration BP is 137/81. Her urine dip is negative for protein.

Ms. Pedroso is a pleasant 36 years old, pregnant females. She became pregnant after a first in-vitro attempted. Currently, the patient is 25 weeks of gestation and has come to the clinic with a chief complaint of recurring heartburn, which she described as a flame-throwing sensation in the epigastric area, abdominal bloating, and a sour taste in the back of her mouth. Ms. Carrillo states noting her symptoms two weeks ago and verbalized the symptoms worsen after eating; particularly after a heavy meal and with certain foods. She describes her pain 8/10 on the pain scale. The patient denies any chest pain or shortness of breath. Ms. Pedroso only known health problem is primary hypertension.

It is our pleasure to see and provide FTS for Ms. Jennifer Mullins. She is a 19yo, G1 P0, with EDD by an 8-week 1-day ultrasound performed in your office giving an EDD of 12/25/17. Her past medical history is notable for morbid obesity with a prepregnancy BMI of 45. She takes prenatal vitamins, denies any surgical history, is normotensive with a normal urine dip here. This is her 1st pregnancy. Her social history is negative x3. Her family history is notable for breast cancer, HTN, diabetes in her maternal grandmother, and heart disease in her as well. She has having occasional nausea, vomiting, and heartburn and says that the Diclegis is not working at all and would like a different prescription.

Serrita is a 26yo, G3 P1011, who was seen for an ultrasound evaluation and fetal anatomy assessment. As you know, she has chronic HTN and is on methyldopa 500 mg b.i.d. Her BP is normal on today’s assessment at 130/78. Her urine evaluation was negative. She is also hypothyroid status-post a diagnosis of Hashimoto’s thyroiditis. She is on replacement therapy. She did undergo noninvasive prenatal testing (NIPT) that returned low-risk, female and her maternal serum AFP was normal at 0.58 MoM. Based on her height and weight at the start of the pregnancy, her BMI was about 38. Lastly, she is on metformin 500 mg b.i.d. She states that she believes that she was on this due to abnormal insulin levels but she was not completely certain as to why

Marie is pale, weak, and anxious, but no longer disoriented. Her fundus is firm and is 1 cm above the umbilicus. She is receiving O2 per nasal cannula at 4 liters/minute and has an O2 saturation of 88%. Her vital signs are: BP 74/44, pulse 116 and respirations 26. Her bleeding has slowed considerably. The nurse asks the UAP to bathe Marie and change the bed linens.

During our initial assessment of Ms. K.R., the following vital signs were noted: blood pressure was 147/67, temp 36.6 degrees Celsius, pulse 80 beats per min., respiratory rate of 20, pulse ox 99% on room air, a pain score of 8 during contractions, and fetal heart tones had a baseline of 130 over the last two hours. Her labs showed 2+ protein in her urine but she denied any headaches, vision changes, right upper quadrant pain, and no DTRs or colonus were observed. Ms.K.R. seemed to be handling her labor well, with the exception of being in a lot of pain and unable to find a comfortable position.

Patient was in the ER room when first seen. PT was with her family members and family states that she speaks little English and that she has had abdominal pain for the past day along with bloody stools. Family states that she is on calcium supplements and no other medications. Last oral intake is 24 hours ago. Family states no known past medical history. Pt is in the hospital bed in the fetal position and towards the right side. Patient's airway is clear and breathing is normal. Skin is warm and dry. Patent is AAOx4. Assessment of head, neck, and chest show no signs of deformities. Abdominal area not assessed due to severe pain. Back is without deformity. The upper extremity shows no sign of deformities or trauma. The lower extremity shows

On ultrasound there is a live fetus in cephalic presentation. Fetal biometry is consistent with dates. A detailed anatomic survey was fairly unremarkable although slightly suboptimal due to late gestational age. There were no gross abnormalities seen. The placenta is anterior. Amniotic fluid was 8.3 cm. Umbilical artery Doppler was within normal limits.

This particular case study involves a 29 year old obstetric patient who presented to the labor and delivery unit at 33 weeks gestation with complaints of abdominal pain for the past three days that had become more severe and absence of fetal movement noted since the previous evening. Her obstetric history revealed she has one living child and has had one previous miscarriage at ten weeks

The onset of her labor was on a Saturday morning. She thought she had had too many tacos, but then she lost her mucus plug. Labor was slow because her cervix would not dilate. She went to the hospital more than once, but the maternity ward would not admit her because her cervix was stuck at two centimeters. The obstetrics staff advised her to walk around which she did. She took multiple hot baths to help with the pain. She was in labor and awake on and off from Saturday morning until Monday night when she finally gave birth at Kaiser hospital in Riverside, California.

Capital punishment or death penalty is punishing by death. Crimes that can attract capital punishment are called capital crimes or offenses. In most countries, capital crimes include murder, robbery with violence, and treason (Doyle 2007). At the moment, there are thirty six countries in the world that practice the death penalty. More than 100 countries have abolished the dead penalty while 6 have prohibited the punishment for normal crimes but still practice it for offenses like war crimes. It is important to establish evidence for the death penalty as a form of deterrent punishment because policies must always be supported by evidence (Doyle 2007).

G4 P3003 (4 Gestations, 3 Full Term, 0 Preterm, 0 Miscarriages, 3 Currently Living); 3 Spontaneous Vaginal Deliveries; Last birth was 7 years ago by SVD, weighed 4000 grams; No previous obstetrical complications or morbidity; No past medical history; No past surgical history; No prior antenatal care

Preeclampsia clinically diagnosed by onset of hypertension after 20 weeks of gestation with the presence of proteinuria, impaired liver and kidney function and hematological complications. Because Preeclampsia characterized by a series of symptoms it can be referred as HELLP syndrome, in which H stands for hemolysis, EL stands for elevated liver enzyme and LP stands for low platelets count. (Turner K & Hammed AB,

The sign and symptoms of PPH include; the apparent excessive bleeding, hematocrit-reduction of the number of red blood cells, reduced blood pressure, development of symptoms of shock and anaemia, and severe pain and swelling of tissues and muscles of the vagina, vulva, pelvic and perineum (Simpson & Creehan, 2008). Besides, Ricci & Kyle (2009) avow that there are different factors that place a mother at risk for PPH, and they comprise; prolonged first, second or third stage of labour, previous history of PPH, foetal macrosomia, uterine infection, arrest of descent and multiple gestation. Other risk factors may include; mediolateral episiotomy, coagulation abnormalities, maternal hypertension, maternal exhaustion, malnutrition or anaemia, preeclampsia, precipitous birth, polyhydramnios and previous placenta previa (Ricci & Kyle, 2009).