Rle Tasks The Case Of Prebbie Zen O Plata Patient S Profile Name Prebbie Cen Plata Age 30 Years Old Gender Female Na 1 (54.96 KiB) Viewed 57 times
Rle Tasks The Case Of Prebbie Zen O Plata Patient S Profile Name Prebbie Cen Plata Age 30 Years Old Gender Female Na 2 (45.69 KiB) Viewed 57 times
RLE TASKS THE CASE OF PREBBIE ZEN O. PLATA Patient's profile Name: Prebbie Cen Plata Age: 30 years old Gender: Female Nationality: Filipino Address: 1850 Inunan St. Sta. Cruz, Manila Religion: Roman Catholic Civil status: Married Occupation: Canteen Helper Attending Physician: Dr. Margie Nalis Date of Admission: July 1, 2021 @ 7:18pm Hospital Number: E18301921 Bed Number OB-8 Chief complaint: Vaginal bleeding (LMP-Nov. 16.2020) History of Present illness: This is a case of Prebbie Zen O. Plata, 30 years old female (G4P3) who was diagnose of Complete Placenta Previa based on the UTZ result. On her 7 month of pregnancy she experienced bleeding amounting to 1 pad slight soaked for 2 days. This prompt her to seek medical attention. She went to local health center, upon assessing by the Health center medical officer she was advised to transfer to Tertiary hospital for further evaluation. And upon transfer to MJRMC thru referral, she was advised by the ER-OB for stat UTZ, and the result revealed that she has a Complete Placenta Previa which lead to "E" CS. The attending Physician ordered prior to OR for CBC, serum electrolyte and for cross matching as part of ancillary test, Order IVF PNSS 1L to run for hours, start Cefazolin IV 950mg after negative skin test then every 12 hours (stock 1g Q-10cc) For BT of 1 pack whole blood and should properly cross matched, inform the Anesthesiologist on duty. For insertion of Catheter and monitor FHT Post op: Delivered a baby Girl with diagnosis of Small for Gestational Age (33 weeks via UTZ) with Apgar's Score of 1" minute of life score of 6 and after 5minutes score of 6 that prompted the Pediatrician advised for stand by intubation, ordered IV therapy of DSIMB 150cc via soluset to run for 12 hours and placed in an incubator with temperature control -30°C. Oxygen flow of 30% and humidity of 65% For continuous maternal and newborn monitoring History of Past illness: In 2018 the patient was hospitalized because of 3 pregnancy with indication of Malpresentation (Breech) and delivered a baby Boy via CS, the neonate undergone treatment for Meconium aspiration syndrome for 2 weeks, Appropriate for Gestational Age (38 weeks) In 2015ennanry was delivered via Normal Santana Delivery hy a Midwife in alvin in clinic
History of Past illness: In 2018 the patient was hospitalized because of 3h pregnancy with indication of Malpresentation (Breech) and delivered a baby Boy via CS, the neonate undergone treatment for Meconium aspiration syndrome for 2 weeks, Appropriate for Gestational Age (38 weeks) In 2015 2° pregnancy was delivered via Normal Spontaneous Delivery by a Midwife in a Lying in clinic to a baby Girl 39 weeks by AOG with no medical indication In 2010 1" pregnancy was delivered via Normal Spontaneous Delivery by a Midwife in a Lying in clinic to a baby Boy 38 weeks by AOG with no medical indication Vital Signs: Temp - 37.9°C PR - 80 bpm RR - 20cpm BP - 110/70mmHg 02 sat - 98% Familial Health History Diabetes Mellitus is present in the paternal side Hypertension in maternal side Personal and Social History: The patient is an occasional drinker and heavy smoker, fond of eating junks foods. Minimal prenatal check-up. Menstrual History: Menarche: 12 years old Interval: 28-30 days' cycle Duration: 3-5 days Amount: 3-4 pads per day Symptoms: (+) Dysmenorrhea
Join a community of subject matter experts. Register for FREE to view solutions, replies, and use search function. Request answer by replying!