Prework:
You are working in a Clinic as a register nurse. Lauren Charles, 32 years old, presents to the clinic for her first prenatal visit after missing her last 2 menstrual cycles and getting a positive pregnancy test result.  Mrs. Charles OB history includes one child who was born at 39 weeks of gestation 3 years ago, another child who died during delivery due to complications of home birth at 40.4 weeks of gestation, and a baby girl who was born 8 months ago at 35.2 weeks of gestation.
Please take few minutes to complete GTPAL for this patient:
· G: 
· T: 
· P: 
· A: 
· L: 
Lauren also presents with other signs of pregnancy, such as amenorrhea, enlargement of breasts, nausea, vomiting, and fatigue. An ultrasound at the clinic confirms pregnancy. 
Please indicate if the following signs of pregnancy are presumptive, probable or positive:
· Pregnancy test: 
· Amenorrhea: 
· Enlargement of breasts: 
· Nausea and Vomiting: 
· Fatigue: 
· Ultrasound image of fetus: 
According to your patient, her last menstrual period was on November 7, 2020. Use Nageles rule to calculate her due date.
· EDD:
After reviewing the nutritional information with you client, she tells you that her baby, that did not survive, had Spina bifida. Lauren is asking is there any specific medications that she should be taking to help prevent this baby from developing NTDs. What supplement will you recommend to the patient?
·  
After reviewing all information with client, you want to determine if she understands the teaching regarding danger signs in early pregnancy. Name 4 reasons why patient should call the provider?
·  
·  
·  
·