Jane is a 42 year old G4P2103. Jane is divorced and works hard long hours as a real estate agent. Jane was having irregular and heavy menses for 6 months and then abruptly 3 months ago they completely stopped. Jane has been having nausea and vomiting for 6 weeks but attributed it to having the flu recently. She also admits to gaining about 10 pounds in the last few months and breast tenderness. Jane comes to the clinic today to discuss menopause symptoms and treatment. During the visit a urine pregnancy test came back positive, on exam you palpate a 16 week size uterus and get fetal heart tones of 165. Jane is in disbelief.
Subjective data, identify both given and needed data
Objective findings, identify both given and needed data
Diagnostic or laboratory testing needed with rationales
List of 3 differential diagnoses with rationales
Medications and or treatments needed with rationales
Patient education needed
Referrals for collaborative care needed with rationales
Make sure to address all sections. Do not leave any section blank.
- Include relevant subjective and physical objective findings.
- Identify appropriate diagnostic and laboratory testing needed.
- List at least three differential diagnoses with rationales for choosing.
- Identify usual medications, treatments, or patient education needed.
- Determine referrals for collaborative care.
- Summarize the case study and include any further research, diagnostics, procedures, or follow-up needed.
- Provide evidence-based references
- use APA 6th Edition format,
- APA formatting and citing
- References less than 5 yrs old