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Camille is a 42 year-old MWF (married white female).

She comes to the


doctors office today seeking confirmation of pregnancy, stating she has missed her
period with her last menstrual period 8 weeks ago. She says her menstrual cycle is
very regular, every 28 days. She also complains of breast tenderness and nausea &
vomiting. The nausea has been so severe she has lost 2.5 kilograms (6 pounds) in
the last five weeks. Her obstetrical history is significant for two miscarriages at six
and ten weeks gestation, eighteen and sixteen years ago respectively, when she
was married to her first husband. After the miscarriages her marriage broke up and
Camille states she was very depressed and gained 25 kilograms (55 pounds) the
following year. In an effort to lose the weight, she became a strict vegan ten years
ago and has not had a weight problem since. Today she is weighs 58.2 kilograms
(128 pounds) and is 175 cm. (5 feet, 9 inches) tall. Her lab work reveals: blood type
A negative, hemoglobin 13 g/dl, hematocrit 37% and a positive pregnancy test.
Based her history and physical exam her pregnancy is dated at six weeks gestation.
1. The symptoms Camille describes are p_________________________ signs of
pregnancy.
2. What is Camilles pregnancy history based on the five digit system?
3. What is Camilles body mass index (BMI)?
4. What is the recommended amount of weight Camille should gain with this
pregnancy?
5. Because Camille follows a vegan diet, discuss the major nutrients she may be
lacking and the best ways to ensure proper nutrition.
6. What is the significance of Camilles Rh negative blood type?
7. What recommendations can the nurse make to ease Camilles nausea and
vomiting?
8. Camille expresses concern over the health of her baby because of her age,
history of miscarriages and the fact that this was an unplanned pregnancy.
What two tests are available to Camille to rule out genetic abnormalities?
Discuss procedures, pros and cons and appropriate gestational age of each.
9. Camille decides against genetic testing as being too invasive with potential
complications. The doctor recommends a Triple Marker test for Camille.
Explain how the test is performed and what information the possible results
may reveal.
10.Camilles pregnancy progresses normally, although she struggles with gaining
enough weight. At her 35 week office visit, the baby is measuring small for
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dates. Camille has also noticed that the baby is not as active as it had been.
Camille is scheduled for a non-stress test (NST). Explain the procedure and
how the results are interpreted.
11.Camilles doctor tells her that the results of the NST were non-reactive and
schedules Camille for a contraction stress test (CST). Camille asks the nurse
what non-reactive means and what a CST is. What is the nurses best
response?
12.The CST is unsatisfactory on two consecutive days. A Biophysical Profile (BPP)
is ordered. Explain to Camille how the test is performed, the five variables
included in the test and how the test is scored.
13.Camilles doctor tells her the results of her BPP are 8/10. He wants her to
complete a Fetal Movement Chart (kick count) and return to the office in one
week bringing the chart with her. Camille asks the nurse if 8/10 is a good
result and what part of the test was abnormal. What is the nurses best
response?
14.Provide Camille with instructions for completing the Fetal Movement Chart
and potential warning signs that should be reported immediately.

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