Phillipa Hudson is a 39-year-old female presenting

Phillipa Hudson is a 39-year-old female presenting today at your clinic with a positive home pregnancy test. Her medical history is negative. Surgical history is remarkable for a c section. Gyn history 1st menses age 12, with cycles coming every 28 days and lasting for 5 days. Her pap and std history are negative. She has been taking a woman’s vitamin for the past 6 years. Her OB history is: Date gestation outcome anesthesia Length of laborweight gender complications 1- 2015 41 weeks nsvd epidural 18 7’6 female none 2- 2016 37 weeks nsvd epidural 6 7’11” female Disappearing twin 3- 2017 39 weeks Primary c/s spinal na 8’2″ male c/s for breech after failed version 3- 2019 6 weeks ectopic Treated with methotrexate Phillipa relates her last period (LMP) was 12-25-2017. She reports breast tenderness, fatigue, and nausea (which is what made her suspect she was pregnant). QUESTIONS: 1. What is Phillipa’s gravidity and parity? 2. When is Phillipa’s due date (EDC)? 3. What other information do you need to give her anticipatory guidance and education? 4. Any concerns? Update: Height, weight, vital signs Phillipa denies smoking, alcohol, and recreational drug use. She is a warehouse supervisor at Amazon and works 36 hrs. per week and teaches yoga 3 nights a week. She and her husband have been together for 15 years, and he works in an accounting office. They live in a 3- bedroom house within easy walking distance to schools and stores. Her husband’s parents live in the same neighborhood they do, and her parents and younger sister live about a mile away. Her vital signs at her first visit height 5’4″ weight 103 lbs. and her BP are 112/68 QUESTIONS: 1. What testing do you order? 2. What anticipatory guidance do you give her? QUESTIONS: Based on this information, what are your next steps? : What is your plan?

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