Case Scenario 2
Table 1
1-hour Oral Glucose Tolerance Test (OGTT) After a 50-g oral glucose load in
pregnant women
Normal Range (Negative)
Abnormal range (Positive)
1 hr
Table 2
Criteria for Abnormal Result on 100-g, 3-Hour Oral Glucose Tolerance Test in
Pregnant Women
Blood Sample
National Diabetes Data
Carpenter and Coustan
Group Criteria
Criteria
Fasting
1 hr
2 hr
3 hr
What defines a positive 3 hr gtt result (failed result)?
Table 3
Define and differentiate between the following Postpartum disorders:
Definition
Signs and
Management of the
symptoms
Diagnosis
Postpartum
Blues
Postpartum
Depression
Postpartum
Obsessive
Compulsive
Disorder
Postpartum
Psychosis
Table 4
Definition
Presentation
(include Signs
and Symptoms)
Management of the
Diagnosis
Puerperal
Fever
Postpartum
Hematoma
Secondary
(delayed)
Postpartum
Hemorrhage
Sore Nipples
Mastitis
Breast Abscess
Jennifer is a G2P1, 31-year-old pregnant female at 24 weeks EGA who has come to
the clinic for her 24-week prenatal visit and recommended screening
tests. Jennifer’s one hour glucose test result is 156 mg/DL. Her BP is 118/78 T
98.7 F, P 68, RR 18, fundal height is 25 cm, no urine/protein in urine, weight is 145
lbs at 5 lbs increased from last visit 4 weeks ago, her height is 5’ 5”.
Write a brief SOAP note regarding this patient. Make sure to include your answers
to these questions in your SOAP note.
1. Subjective:
a. What other relevant questions should you ask regarding the HPI?
b. What other medical history questions should you ask?
c. What other OB history questions should you ask?
2. Objective:
a. Describe the appropriate physical assessment that needs to be
included in this visit.
b. Explain what test(s) you will order and perform, and discuss your
rationale for ordering and performing each test.
3. Assessment/ Diagnosis:
a. What is your diagnosis?
b. Include any appropriate differential diagnosis
4. Plan:
a. If the patient fails her 3 hr gtt, what is the next course of action?
b. Explain what medication regimen this patient could be on?
c. What education can you include with this patient?
d. Explain complications that can occur if patient does not comply with
treatment regimen.
e. If the patient passes her 3 hr gtt, what is the next course of action?
Would you diagnose her as GDM?
f. What patient education is important to include for this patient?
Provide evidence from the research to support your decision-making.