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 well-woman comprehensive exam includes, in general, an evaluation of the medical and family histories, a physical examination, including breast and pelvic exams, laboratory tests, as well as health counseling. Physical exam includes checking vitals such as temperature, blood pressure, respiration rate and heart rate.

According to the case, chronic hypertension is the main diagnosis. High blood pressure diagnosed or present prior to pregnancy is considered chronic hypertension. These features are indicative of a blood pressure that is elevated. This can lead to complications like preeclampsia and eclampsia.

Labetalol is used in this case study to treat high blood pressure during pregnancy. Later, Nifedipine (as a second blood pressure medication) was prescribed. Throughout her stay in the hospital and even after discharge, the patient’s blood pressure was monitored and she underwent fetal tests and frequent BP check-ups to make sure that both mother and child were safe.

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. Primary diagnosis of the patient studied in this case is severe chronic hypertension, and it was controlled with frequent monitoring.