Situation: Karen is a 30 year-old woman, 16 weeks pregnant, who comes for a first prenatal visit.She is conncerned because she did not realize she was pregnant until a week ago. Because of thhis she has been actively dieting (2 diet drinks plus one meal of vegetables daily) plus lifting weights at a health club. Karen wants her urine tested because “ I have to go alll the time”. She doesn't want any blood work done because Karen does not have any insurance. Karen has not had a pelvic examination since she was in senior high school, when she had a vaginal infection. Karen is single, lives by herself in one-bedroom. She is working at a laundry shop and her boyfriend is a salesman, out of town 5 days a week. Karen had her menarche at the age of 11; menstrual cycle every 28 days, 6 days duration with moderate flow and mild cramps. Past history positive for sinusitis and appendectomy at age 12 years. Smokes about ½ pack of cigarettes per day (“more when I’m stressed at work”); denies alcohol use. Karen weighs 190 pounds and stands 5 feet 3 inches breast full and slightly tender. Pelvic examination:             Cervical os roound, clean, and slightly soft; uterus ennlarged and soft; + chadwicks; + hegar’s sign; + Goodell’s sign; uteriine height palpaable at 3 fingers over symphysis pubis. Fetaal heartrate via Dopppler at 152 beats per minute. Other physical examination results are within normal limits. Serum HCG and ultrasound positive for pregnancy. Answer the following: Pertinent Menstrual History Menarche: Cycle: Amount:

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Situation:

Karen is a 30 year-old woman, 16 weeks pregnant, who comes for a first prenatal visit.She is conncerned because she did not realize she was pregnant until a week ago. Because of thhis she has been actively dieting (2 diet drinks plus one meal of vegetables daily) plus lifting weights at a health club. Karen wants her urine tested because “ I have to go alll the time”. She doesn't want any blood work done because Karen does not have any insurance. Karen has not had a pelvic examination since she was in senior high school, when she had a vaginal infection.

Karen is single, lives by herself in one-bedroom. She is working at a laundry shop and her boyfriend is a salesman, out of town 5 days a week.

Karen had her menarche at the age of 11; menstrual cycle every 28 days, 6 days duration with moderate flow and mild cramps. Past history positive for sinusitis and appendectomy at age 12 years. Smokes about ½ pack of cigarettes per day (“more when I’m stressed at work”); denies alcohol use.

Karen weighs 190 pounds and stands 5 feet 3 inches breast full and slightly tender.

Pelvic examination:

            Cervical os roound, clean, and slightly soft; uterus ennlarged and soft;

+ chadwicks; + hegar’s sign; + Goodell’s sign; uteriine height palpaable at 3 fingers over symphysis pubis. Fetaal heartrate via Dopppler at 152 beats per minute.

Other physical examination results are within normal limits. Serum HCG and ultrasound positive for pregnancy.

Answer the following:

  1. Pertinent Menstrual History

Menarche:

Cycle:

Amount:

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