Case Study: Chronic Hypertension

Female was admitted to inpatient care with a diagnosis of chronic hypertension with severe features and started on Labetalol 200 mg po q 8 hours. She was monitored for 3 days and her BP stabilized at 130/78. Fetal testing was reassuring. She was discharged home on hospital day 3 on Labetalol and was to be seen twice weekly for BP checks, and was instructed to take her BP at home twice daily. Safety of medications was discussed in-depth with her. Signs/symptoms of PIH were reviewed with her. Two weeks later she had po nifedipine added. She subsequently delivered a healthy baby girl at 39 weeks gestation. She was discharged home on above medications (as she was breastfeeding) and continued meds for hypertension past her 6-week postpartum appointment. She was referred to her primary care provider for continuing care. 

Purpose of this case study is to address the significantly different standards of labs and vital signs for pregnant patients. 

· Based on the case study above, complete a comprehensive well-woman exam 

· What is your primary diagnosis? Explain. 

· What are two other differential diagnoses? Explain.

· What additional questions you would ask the patient? Explain your reasons for asking the additional questions

· Then, what types of symptoms you would ask for? Be specific and provide examples. (Note: When asking questions, consider sociocultural factors that might influence your question decisions.)

· Lastly, explain which treatment options and diagnostic tests you might recommend