I encountered a Hispanic-American woman aged 34-year-old who was having her second pregnancy with one live birth and no history of abortion. She had come to the clinic for the prenatal care and was at week 24 of gestation. Her blood pressure was 13080 mmHg; weight was 220 lb. The uterine size is well related to the gestational age. The past obstetric history of the patient includes virginal delivery of a male infant at 40 weeks of gestation Loic Remy Jersey , and he weighed 9lb, 8oz. He was born three and a half years ago in New York. The first child is doing well according to the patient (Schuiling, &Likis, 2013). The family history of the patient is that her father has type II diabetes Mellitus and mother is healthy. Test from urine dipstick indicates negative ketones and 3+ glycosuria. It was clear that the patient had several risk factors for GDM involving carbohydrates intolerance and various degree of severity with first recognition and onset during pregnancy with no regard to whether or not insulin was used in treating the conditions persistence after pregnancy or for other treatments. She is also above the age of 30 Kyle Scott Jersey , and her ethnic group has an increased risk of acquiring type 2 diabetes mellitus. She has a first degree relative with diabetes and is obese.
Findings indicated significant glycosuria which called for the need to undertake glucose determination. The patient was started on both insulin therapy and dietary insulin control. Her diet comprised of 25 kcalkg of her body weight that needed to be divided into three meals and she was to avoid bedtime snacks. She was advised to stop talking simple carbohydrates and instead take the complex ones. She was also taught on using the self-monitoring kit for blood glucose and to take the tests while fasting and two hours after each meal. Follow-up was done six weeks after the 30 weeks gestation, and the regimen was working well. Fetal movements were undertaken to determine fetal well-being and measuring his heart rate twice weekly for the remainder of her pregnancy (Tharpe, Farley, & Jordan Kenedy Jersey , 2013). From the tests, it became possible to diagnose the patient with diabetes mellitus since her plasma glucose was at 128 mgdl.
References
Schuiling, K., &Likis Jeremie Boga Jersey , F. (2013). Women鈥檚 Gynecologic health (2nd ed.). Burlington, MA: Jones and Bartlett Publishers.
Tharpe, N., Farley Jake Clarke-Salter Jersey , C., & Jordan, R. (2013). Clinical guidelines for Women鈥檚 health (4th ed.). Burlington, MA: Jones & Bartlett Publishers.
Sherry Roberts is the author of this paper. A senior editor at Melda Research in Help Me Write My Essay For Me services. If you need a similar paper you can place your order for a custom research paper from pay someone to write research paper services.
Total Views: 14Word Count: 456See All articles From Author The 10 Greatest Puppy Training Tips of All Time According to Dog Training Experts
10) When trying to settle a puppy into a new home Gary Cahill Jersey , providing them with a warm hot water bottle and placing a ticking clock in the room where they sleep will help to replicate the body heat and heartbeat of their litter mates and can really help them to relax in their new environment.
9) When taking your puppy to the Vet for its first inoculations, health checks etc, it is good practice to sit with your puppy on your lap and not have him or her on the floor. Apart from being able to comfort and re-assure the puppy easier in this position you must also consider the fact that there may be a number of sick animals in the surgery and your puppy is vulnerable if they come into direct contact with infectious animals that may also be in attendance at the same time as your pup. Make a very deliberate effort to ensure your puppy's trips to the vets are as fun as you can make them. Don't allow your puppy to think you are nervous or concerned, instead make a game and even take a toy to amuse the puppy with whilst they sit on your lap.
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7) Try to make sure your puppy is entertained adequately for short but regular intervals during the day. Long periods of being left unstimulated may lead to destructive or disruptive behaviour later in life. Little games playing 'fetch' with the pup's favourite toy will have the beneficial affect of stimulating the pup, increasing his or her bond with you and allowing the pup to expend short, sharp bursts of energy.
6) Don't over-train your puppy. Remember, a one-year old dog is Ethan Ampadu Jersey , effectively, the same as a seven-year old person. It is a good rule of thumb to keep reminding yourself 'would I expect a three, four, five or six-year old child to accomplish some of the tasks I am asking of my pup?' Manners Eduardo Jersey , house-cleanliness and the very basics (including socialisation) are all you should really seek to instil in your puppy until such a time, as they are mature enough to undergo a more formal training regime. Puppies can deceive you into thinking they are ready for training but will ultimately 'rebel' against discipline as they get older. Ensuring you have taught your puppy to respond to his or her name, what is and is not acceptable in terms of house-manners and establishing an uninhibited relationship with your pup is more important than any other discipline in the early stages of any dog's life.
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