Of the following, what are C.S’s risk factors: Substance use/abuse, Stress, Sedentary lifestyle and lack of exercise and personal fitness, Exposure to intimate partner, family, or stranger violence? Provide a rationale for your selections.

This patient’s risk factors are abundant in this situation that could cause harm to the patient as well as the baby. The patient’s risk factors are that the patient is currently smoking, has a lack of prenatal care, expresses high levels of stress, poor diet, and a seizure disorder. The patient does not express that there is any substance use/abuse or any exposure to violence which helps to reduce the effect on the patient’s health as well as the baby’s (Duko et al., 2021). Cigarette smoking increases the risk of cancer as well as heart disease and it strongly affects fetal growth (Traylor et al., 2020). Also, the patient has a high caffeine intake which restricts fetal growth, for example in an 8-ounce cup of regular coffee, the average caffeine content is 137 milligrams while a 12-ounce of cola contains about 37 milligrams (Traylor et al., 2020). Experiencing abuse of any sort during pregnancy can be truly detrimental to the baby’s health such as causing low birth weight, fetal injuries, and unhealthy maternal behaviors which can lead to many issues therefore it is good that it is not mentioned in the above scenario (Duko et al., 2021). Stress can be extremely detrimental to the fetal growth and development because it can sensitize the body’s inflammatory response which increases the risk for depression after the patient has a seizure which can affect the fetal growth and development if the seizure disorder is not controlled. 


What additional questions should be asked to gain an understanding of the present illness?

Questions that should be asked to better gain an understanding of the present illness would be to examine the severity of the symptoms as well as the duration of the cough, fever, sore throat, and runny nose (Duko et al., 2021). It is also important to examine the past medical history and if there are any other present conditions that the patient suffers with as well as current medications or allergies (Traylor et al., 2020). Also, the symptoms should be examined as well in more detail such as the color of the sputum and is the cough productive as well as, has the patient taken any over the counter medications to help out with these symptoms (Duko et al., 2021). The patient can also be asked if they have been around anybody that has been sick and what they were diagnosed with to help guide the treatment plan. 


What would be included in the review of systems?

In the review of systems, it is important to conduct a comprehensive assessment by doing a full head to toe such as asking about any chest pain, shortness of breath, fatigue, headaches, vision changes or hearing changes, as well as any mental status issues (Traylor et al., 2020). The patient can also be asked about their skin and if they have any current skin conditions as well as complete a depression screening (Duko et al., 2021). The patient should be asked if they have been around anybody who has been sick as well as when their last seizure was and if they are taking their medication as prescribed (Traylor et al., 2020). The patient should be asked if they have experienced any nausea or vomiting as well as any weight gain. The patient would be assessed for experiencing any spotting or fluid leakage that is out of the normal as well as experiencing any morning sickness during the pregnancy (Duko et al., 2021). Also, that the patient should be assessed for how often they smoke and if they would be open to smoking cessation or at least reducing the amount during the pregnancy (Traylor et al., 2020). The patient should also be asked about the first baby’s route of delivery and their birth weight and if they had any pregnancy complications with the first one. 


Discuss the elements of an abbreviated physical examination.

The elements of an abbreviated physical examination are looking into the patient’s vital signs such as heart rate, blood pressure, respiratory rate, and temperature. This will also look into the patient’s examination of their head, neck, chest, and lungs as well as looking into their extremities’ strength and palpating their abdomen (Duko et al., 2021). It is very important to look into any health issues that could be occurring based upon the present symptoms from the physical examination and this should be completed quite frequently to ensure normal anatomy (Duko et al., 2021). Also, this will look into listening to the fetal heart tones and measuring the fundal height to ensure that the fetus’s growth and development is adequate (Traylor et al., 2020). The patient should also be recommended to complete a smoking cessation program and be referred to a high-risk pregnancy specialist in order to monitor the fetus safely during the pregnancy. 


List 2 community resources in your area to which you could refer Ms. S.

There are a variety of community resources in this author’s area that this patient could be referred to help assist in the current situation such as the Life Way Clinic which offers low cost or free medical care and resources to pregnant women and new mothers (Duko et al., 2021). Also, the Precious Care Clinic which helps to provide free prenatal care and support to the pregnant woman as well as offers a smoking cessation program which would be extremely beneficial to this patient. 

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