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. 

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A comprehensive well-woman exam typically includes a review of medical and family history, a physical exam (including breast and pelvic exams), laboratory tests, and health counseling. The physical exam would include checking vital signs such as blood pressure, heart rate, respiratory rate, and temperature.

Based on the case study, the primary diagnosis of the patient is chronic hypertension with severe features. Chronic hypertension is defined as high blood pressure that was present before pregnancy or diagnosed before 20 weeks of gestation. Severe features indicate that the blood pressure is significantly elevated, posing a risk of complications such as preeclampsia, eclampsia, and placental abruption.

The patient in the case study was started on Labetalol, which is a medication used to control high blood pressure in pregnancy. Nifedipine was added later as a second medication to control blood pressure. The patient was closely monitored throughout her hospital stay and after discharge with frequent BP checks and fetal testing to ensure the safety of the mother and baby.

In conclusion, a comprehensive well-woman exam is an essential component of women’s health care, particularly during pregnancy when certain conditions such as chronic hypertension can pose significant risks. The primary diagnosis for the patient in the case study is chronic hypertension with severe features, which was managed with medications and frequent monitoring.