l.

FEFSCN/L D/I/:

Mr:. C8, c 37 yecr-c|c mcIher cf 3 i: currenI|y re:icing :cmewhere in
Mcni|c wiIh her hu:Lcnc Mr. Gyne. She wc: Lcrn c Fi|ipinc cn DecemLer 02,
172 in Mexicc, Fcmpcngc. Ihe pcIienI wc: ccmiIIec cI c :eccnccry
hc:piIc| wiIh c chief ccmp|cinI cf pre-mcIure |cLcr |c:I NcvemLer 11, 2010 cI
crcunc 2:20 pm.

ll. HlSICFY:
/. Chief Ccmp|cinI

Ihe pcIienI wc: ru:hec Ic Ihe hc:piIc| cue Ic pre-mcIure |cLcr. Her
|c:I men:IrucIicn pericc wc: cn Mcrch 27, 2010 c: :he ncIec. 8uI ccccrcing
Ic her u|Irc:cncgrcphy, her EDC wi|| Le cn Ihe 27
Ih
cf NcvemLer cf Ihe :cme
yecr. Ihi: wi|| Le her 4
Ih
LcLy which give: her cn cL:IeIric hi:Icry cf
G4F3I3F0/0L3M0.

8. 8rief Hi:Icry

Mr:. C8 i: currenI|y :Icying wiIh her fcmi|y cf prccrecIicn :cmewhere in
Mcni|c where :he wcrk: c: c ccck in c :mc|| ccrinceric. /cccrcing Ic her, :he
prefer: Ic ce|iver her 4
Ih
LcLy here in Fcmpcngc, cue Ic fincncic| ccn:IrcinI:
cnc :he wi|| :Icy cI Mexicc fcr :cme Iime cf reccvery wiIh her mcIher.

Ihe pcIienI c|:c verLc|izec IhcI Ihey cre uncer fcmi|y p|cnning. Her
chi|cren were cgec 12, 10, re:pecIive|y. Ihi: pregncncy cf her c: cf Ihe
mcmenI wi|| Le her |c:I cnc Ihey cre cecicec IhcI :he wi|| Le uncergcing
Li|cIerc| IuLc| |igcIicn cI Ihe :cme Iime c: :he wc: :checu|ec Cec:cricn
SecIicn in Iwc week: Iime.

During her chi|chccc yecr:, Mr:. C8 repcrIec IhcI :he hcc mec:|e:
cnc nc mcncgemenI wc: ccne. /: cccec Ly her mcIher, whc wc:
wcIching cver her cI IhcI ccy cf ccnfinemenI, her ccughIer receivec
vcccincIicn:, pricr Ic immunizcIicn.

Mr:. C8 wc: rci:ec c: c Fcmcn CcIhc|ic cnc :he verLc|izec IhcI :he
hc: nc :uper:IiIicu: Le|ief: cLcuI pregncncy. When iI ccme: cn hec|Ih
mcIIer:, :he ccmiIIec IhcI Ihey cc :e|f-meciccIicn where in Ihey Luy cver-
Ihe-ccunIer crug: |ike pcrcceIcmc|. 8uI when :ericu: mcIIer: cri:e :he :Ii||
prefer: Ic :eek mecicc| prcfe::icnc|: he|p.

Fricr Ic her pregncncy, :he cn|y hcc 2 check-up: cnc :he repcrIec
cc:e: cf hecccche where Ihe phy:icicn pre:criLec her Ic Icke mefencmic
ccic. When c:kec cLcuI viIcmin :upp|emenI: inIcke, :he :cic IhcI i: Icking
ircn :upp|emenI: which were Leing :enI Ic her Ly her :i:Ier in Ihe UniIec
SIcIe:. She fcrgcI Ihe ncme cf Ihe crug. WiIh regcrc: Ic exerci:e, :he
ccn:icer: hcu:ehc|c chcre: c: cne. She cccec IhcI :he Icke: p|enIy cf wcIer
cnc ecI: fruiI: c: her cieI.
Mr:. C8 c|:c verLc|izec IhcI :he experiencec :en:iIiviIy pricr Ic her
pregncncy. During her 1
:I
Irime:Ier, :he u:ec Ic ecI cn|y Li:cuiI:. She c|:c crink: 1
cup cf ccffee every mcrning. She cce:nI :mcke ncr crink c|cchc|ic Levercge:.
Cn her 2
nc
cnc 3
rc
Irime:Ier :he ncIec chcnge: in her pregncncy :uch c: :Irice
grcviccrum, |inec nigrc, & me|c:mc. WiIh her ccIiviIie: cf cci|y |iving, :he wcke:
up crcunc 3cm Ic gc Ic Ihe mcrkeI cnc Luy Ihe ingrecienI: fcr Ihe menu :he wi||
Le cccking. Ihey :erve fccc Ii|| evening IhcI: why :he :|eep: |cIe.


lll. /SSESSMENI

/. ViIc| Sign::

IempercIure: 3C
Fu|:e FcIe: 88 Lpm
Fe:pircIcry FcIe: 23 cpm
8|ccc Fre::ure: 100/70 mmHg

8. Feview cf Sy:Iem:
Fhy:icc| /::e::menI:

c. Generc| /ppecrcnce
Mr:. C8, 37 yecr: c|c, c::uming c :emi-fcw|er: pc:iIicn, ccherenI cf
Ihe ccIe cnc p|cce wc: receiving cn cngcing lVF cf D5W 500 cc + ll
cmp: IerLuIc|ine x -10 mgH:/min infu:ing we|| cn her |efI crm. She wc:
ncIec Ic Le c||evicIec frcm pcin wiIh c :ccre cf 1 in pcin :cc|e cf 1-10
{10 i: Ihe mc:I pcinfu|).

L. /::e::menI cf Ihe Hecc
Hecc i: rcunc in :hcpe wiIh even|y ci:IriLuIec L|cck hcir cnc nc
infe:IcIicn:. Ihere i: :ymmeIric fccic| fecIure: cnc mcvemenI:. Nc
nccu|e: cr mc::e: pc|pcIec.

c. /::e::menI cf Ihe Eye:
Eye: cnc eyeLrcw: cre :ymmeIricc||y c|ignec wiIh eye|c:he:
euc||y ci:IriLuIec cnc cur|ec :|ighI|y cuIwcrc cnc wiIh Li|cIerc|
L|inking exhiLiIec.

c. /::e::menI cf Ihe Ecr:
Ihe ecr: cre :ymmeIricc||y c|ignec wiIh cc|cr :cme c: fccic| :kin
cnc nc |e:icn: cnc cerumen ncIec.

e. /::e::menI cf Ihe Nc:e
Nc ci:chcrge cr f|cring ncIec.

f. /::e::menI cf Ihe McuIh
Lip: cre in unifcrm pinki:h cc|cr.

g. /::e::menI cf Ihe Neck
Ihe hecc i: in Ihe cenIer. Ihere cre nc |ymph ncce: pc|pcL|e.

h. /::e::menI cf Ihe HecrI
8|ccc pre::ure cf 100/70 mmHg wiIh c pu|:e rcIe cf 88 Lpm,
re:pircIcry rcIe cf 23 cpm. Fegu|cr cnc wiIh fu|| pu|:cIicn.

i. /::e::menI cf Ihe 8rec:I
Ihe Lrec:I: cre en|crgec LuI nc Iencerne:: ncIec.

j. /::e::menI cf Ihe /Lccmen
SIrice grcviccrum wc: ncIec, |inec nigrc i: pre:enI. Nc Iencerne::.

k. /::e::menI cf Ihe Lcwer ExIremiIie:
Mu:c|e cre cf euc| :ize cn LcIh :ice: cf Ihe |eg wiIh nc Lcne
cefcrmiIie: cnc nc Iencerne::.



Ihe Femc|e FeprccucIive Sy:Iem cnc cIher Sy:Iem: /::ccicIec wiIh Fregncncy
Ccrcicvc:cu|cr Sy:Iem: Ccrcicc CuIpuI increc:e: 30 Ic 507 Leginning Ly
wk ge:IcIicn cnc pecking LeIween 1 & 28 wk {u:uc||y cI cLcuI 24 wk).
lI remcin: necr peck |eve|: unIi| cfIer 30 wk. Ihen CC Leccme: :en:iIive Ic
Lccy pc:iIicn. Fc:iIicn: IhcI ccu:e Ihe en|crging uIeru: Ic cL:IrucI Ihe
venc ccvc Ihe mc:I {e.g. Ihe recumLenI pc:iIicn) ccu:e CC Ic cecrec:e
Ihe mc:I.
- /cccrcing Ic Ihe c|ienI, :he u:uc||y c::ume: c :ice-|ying pc:iIicn which
mcke: her mcre ccmfcrIcL|e. /: cf Ihe mcmenI :he hc: c pu|:e rcIe
cf 88 Lpm cnc c L|ccc pre::ure cf 100/70 mmHg.

HemcIc|cgi: IcIc| L|ccc vc|ume increc:e: prcpcrIicnc||y wiIh CC, LuI wiIh
Ihe increc:e p|c:mc vc|ume Ihcn IhcI in F8C mc::. Ihu:, HL i: |cwerec Ly
ci|uIicn ccu:ing ge:IcIicnc| cnemic which cecrec:e: L|ccc vi:cc:iIy. lrcn
reuiremenI: increc:e Ly c IcIc| cf cLcuI 1g curing Ihe enIire pregncncy
cnc cre higher curing Ihe 2
nc
hc|f cf pregncncy Ic 7 mg/ccy.
- Ihe c|ienI verLc|izec IhcI :he i: Icking ircn :upp|emenI:.

Urincry: Chcnge: in renc| funcIicn rcugh|y pcrc||e| Ihc:e in ccrcicc
funcIicn. Fc:Iurc| chcnge: cffecI renc| funcIicn mcre curing pregncncy,
i.e Ihe :upine pc:iIicn increc:e: renc| funcIicn mcre cnc uprighI pc:iIicn:
cecrec:e renc| funcIicn.
- Ihe c|ienI ncIec freuenI urincIicn which :he rep|cce Ly crinking
p|enIy cf wcIer.

/ncIcmy cf Ihe Femc|e FeprccucIive Sy:Iem
/|| |iving Ihing: reprccuce. FeprccucIicn - Ihe prcce:: Ly which
crgcni:m: mcke mcre crgcni:m: |ike Ihem:e|ve: - i: cne cf Ihe Ihing: IhcI :eI:
|iving Ihing: cpcrI frcm ncn-|iving mcIIer.

Ihe Mcmmcry G|cnc:
- Specic|izec in :ecreIing mi|k fc||cwing pregncncy

Cervix
- Ihe |cwer cne-Ihirc cf Ihe uIeru: i: Ihe IuLu|cr cervix" which exIenc:
ccwnwcrc inIc Ihe upper pcrIicn cf Ihe vcginc. Ihe cervix :urrcunc:
Ihe cpening cc||ec cervicc| crifice" Ihrcugh which Ihe uIeru:
ccmmuniccIe: wiIh Ihe vcginc.

Fc||cpicn IuLe:
- Ccrrie: egg cnc :perm cnc i: where ferIi|izcIicn cf Ihe egg Icke:
p|cce.

Cvcrie:
- Frccuce: egg: cr cvc cnc c|:c re:pcn:iL|e in prccucing e:Ircgen cnc
prcge:Iercne

UIeru:
- Ihe wcmL, where Ihe ferIi|izec egg i: ncuri:hec cnc c||cwec Ic
ceve|cp unIi| LirIh

Vcginc
- Mu:cu|cr pc::cge which fcrm: c pcrI cf Ihe femc|e :ex crgcn: cnc
which ccnnecI: Ihe neck cf Ihe uIeru: wiIh Ihe exIernc| geniIc|:.




















lV.
Li:I cf McncgemenI
Fencerec
DcIe Ferfcrmec De:cripIicn FcIicnc|e
lncepencenI
1.E:IcL|i:hec
rcppcrI wiIh Ihe
c|ienI
11-12-10 @ 1:15 pm Ihi: i: ccne Ly
inIrccucing :IucenI
nur:e: ncme,
greeIing: cnc
c:king Ihe c|ienI:
ncme
Ic gcin c|ienI: Iru:I
cnc cccpercIicn
2.GeI, reccrcec
cnc mcniIcrec viIc|
:ign:
11-12-10 @ 1:20 pm Ihi: i: ccne Ly u:ing
IhermcmeIer, 8F
cpp, cnc pc|pcIicn
cf pu|:cIicn:
Ic hcve c Lc:e|ine
ccIc Ic Le
ccmpcrec fcr fuIure
c::e::menI cnc
fincing:
3./::e::ec Ihe
c|ienI: generc|
ccnciIicn
11-12-10 @ 1:30 pm Ihi: i: ccne Ihrcugh
cL:ervcIicn cnc
reccing pcIienI:
chcrI
Ic kncw Ihe currenI
:IcIu: cf Ihe pcIienI
cnc Ic check cn
whcI hec|Ih ccre
cnc Iecching i:
neecec Ly Ihe
c|ienI
4.ln:IrucIec c|ienI Ic
increc:e f|uic inIcke
11-12-10 @ 1:40 pm Ihi: i: ccne Ihrcugh
verLc|
ccmmuniccIicn c:
pcrI cf hec|Ih
Iecching:
F|uic i: impcrIcnI Ic
prevenI
cehycrcIicn
LrcughI cLcuI Ly
freuenI urincIicn
5.ln:IrucIec c|ienI Ic
ecI fccc: rich in
fiLer
11-12-10 @ 1:45 pm Ihi: i: ccne Ihrcugh
verLc|
ccmmuniccIicn c:
pcrI cf hec|Ih
Iecching:
FiLer-rich fccc: ccn
ccc up Ic Ihe
Lu|kine:: cf Ihe
:Icmcch cnc
prcmcIe regu|cr
cefcccIicn
prevenIing
ccn:IipcIicn
.ln:IrucIec c|ienI Ic
hcve encugh :|eep
cnc re:I
11-12-10 @ 1:50 pm Ihi: i: ccne Ihrcugh
verLc|
ccmmuniccIicn c:
pcrI cf hec|Ih
Iecching:
Ic re:Icre energy
cnc Ic cvcic
ccnIrccIicn: {pre
mcIure |cLcr)
DepencenI
1./cmini:Ierec ViI.
Supp|emenI: c: per
crcer
11-12-10 @ 1:55 pm Ihi: i: ccne Ly
giving Ihe
pre:criLec crug: Ic
Ihe pcIienI
I prcmcIe we||ne::
Ic LcIh mcIher cnc
feIu:
2.Fegu|cIec lVF c:
per crcer
11-12-10 @ 1:58 pm Ihi: i: ccne Ly
:|cwing cr :peecing
Ihe f|cw cf lVF
Ic prevenI vencu:
Ircumc LrcughI Ly
Ihe cver|cccing
f|uic: cn Ihe :iIe cf
lVF
lnIercepencenI
1.Feferrec Ic c
nuIriIicni:I
11-12-10 @ 2:00 pm Ihi: i: ccne Ly
Ie||ing Ihe pcIienI Ic
c:k fcr Ihe he|p cf c
nuIriIicni:I regcrcing
fccc mccificcIicn:
Ic mccify c|ienI:
cieI ccccrcing Ic
her neec:


V. Feference:
O Mcri|ynn E., eI. c| {2008). Nur:e: FcckeI Guice {11
Ih
eciIicn)
O www.kic:hec|Ih.crg
O www.innerLccy.ccm