using the case information and best evidence, complete the chart below. Make sure to address all columns in the chart.
Sara is a 32-year-old G1P1001. She presents to your office for a 6-week postpartum check following a normal vaginal delivery of a healthy baby girl. Sara had an 18-hour labor with Pitocin augmentation and delivered a 7 pound 2 oz. girl with a second degree laceration repaired with sutures. Sara spent 2 days in the hospital and was discharged home with her infant and husband. Over the last few weeks, Sara has called the office multiple times with questions about breastfeeding and her sutures healing. Upon walking into the exam room to see Sara, you see her baby in the stroller crying and Sara sitting on the exam table crying into her hands.
Description of the case chosen:
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 three 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.
Your writing Assignment should:
- follow the conventions of Standard English (correct grammar, punctuation, etc.);
- be well ordered, logical, and unified, as well as original and insightful;
- display superior content, organization, style, and mechanics; and
- use APA 6th Edition format.