Discuss what questions you would ask the patient, what physical exam elements you would include, what further testing you would want to have performed, differential and working diagnosis, treatment plan, including inclusion of complementary and OTC therapy, referrals and other team members needed to complete patient care.
Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.
CASE STUDY: Malia, a 23-year-old female presents to the clinic for her initial OB visit. She says she did not know she was pregnant initially, but believes she is about 6 months pregnant now, and reports positive fetal movement. She states she was smoking about half a pack of cigarettes a day, but when she found out she was pregnant she stopped smoking. She has not received any prenatal care. This is her third pregnancy. Her previous pregnancies both delivered early, one at 20 weeks that did not survive, and the second at 32 weeks where the infant survived. Today, she complains of a backache that she has had for two days. Currently, she is unemployed and is supported by family. Her exam reveals the following: height 5’6”, weight 156, FH 27cm, FHR 152, BP 122/78, positive nitrates in urine, and positive bacterial vaginosis by micro.
What lab tests and diagnostic screenings will you order, and why?
What medications would you prescribe and what patient education will you provide?
Provide evidence from the research to support your decision-making.
