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    Interview Sheet

    Uploaded by

    Sheryhan Tahir Bayle
    Andrea Newman is a 30-year-old Caucasian woman who works as a drugstore clerk and is currently in school. She has two living children ages 3.5 and 4.5 years old and had previously undergone fertility treatment and a therapeutic abortion. Based on her last menstrual period 6 weeks ago with a regular 7-day cycle, her estimated due date is January 22, 2020 and current gestational age is 1 week and 4 days. Her obstetrical history includes a gravidity of 2 and parity of 2, with 1 therapeutic abortion and 2 living children.

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    Interview Sheet

    Uploaded by

    Sheryhan Tahir Bayle
    36 views3 pages
    Andrea Newman is a 30-year-old Caucasian woman who works as a drugstore clerk and is currently in school. She has two living children ages 3.5 and 4.5 years old and had previously undergone fertility treatment and a therapeutic abortion. Based on her last menstrual period 6 weeks ago with a regular 7-day cycle, her estimated due date is January 22, 2020 and current gestational age is 1 week and 4 days. Her obstetrical history includes a gravidity of 2 and parity of 2, with 1 therapeutic abortion and 2 living children.

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    Interview-sheet

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    Andrea Newman is a 30-year-old Caucasian woman who works as a drugstore clerk and is currently in school. She has two living children ages 3.5 and 4.5 years old and had previously undergone fertility treatment and a therapeutic abortion. Based on her last menstrual period 6 weeks ago with a regular 7-day cycle, her estimated due date is January 22, 2020 and current gestational age is 1 week and 4 days. Her obstetrical history includes a gravidity of 2 and parity of 2, with 1 therapeutic abortion and 2 living children.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    36 views3 pages

    Interview Sheet

    Uploaded by

    Sheryhan Tahir Bayle
    Andrea Newman is a 30-year-old Caucasian woman who works as a drugstore clerk and is currently in school. She has two living children ages 3.5 and 4.5 years old and had previously undergone fertility treatment and a therapeutic abortion. Based on her last menstrual period 6 weeks ago with a regular 7-day cycle, her estimated due date is January 22, 2020 and current gestational age is 1 week and 4 days. Her obstetrical history includes a gravidity of 2 and parity of 2, with 1 therapeutic abortion and 2 living children.

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    You are on page 1of 3

    Client Name: Andrea Newman Age at conception: 30

    Race/Ethnicity/Tribal affiliation: Caucasian woman

    Occupation: works as a drugstore clerk Currently in school? Y or N: Y


    Living/housing situation: with husband and two children Currently working or not? Y or N: Y
    Primary language spoken English Language Barriers: Y or N: N

    Questions

    I am going to ask some questions to better help us support you during this pregnancy. This
    information will be kept confidential. Please let me know if you have any concerns or
    questions as we go along.
    1. Are you pregnant?
    Answer: “I think I'm pregnant"

    (If seen by a medical provider) Has your medical provider told you about any health or
    medical concerns with your current pregnancy, such as high blood pressure, gestational
    diabetes, preterm labor, or pregnant with two or more babies?
    Couple had been attending a fertility clinic because they had not been using a
    contraceptive for 2½ but could not seem to conceive. Husband's sperm count was found
    to be subnormal.
    2. What is your current weight? 238 pounds
    Height: 5'7 (feet and inches).

    3. Is this your first pregnancy? Y or N? N

    (If no)
     How many times have you been pregnant? 2, she has 3½- and 4½-year-old children
     Have any of them been miscarriage, stillbirth or early infant death? Y or N (if yes)
    How many and when? Y she had therapeutic abortion at age 18
     When did your last pregnancy end? Male, born 3 years ago
     Did you have fertility treatment with this pregnancy? Y or N? Y Andrea had a mild
    endometritis treated with intravenous antibiotics for 4 days following birth. Feels
    this was the reason for her infertility.
    4. Do you have any health problems?
    age 16 she undergoes Appendectomy, "Bad" adolescent acne treated with tetracycline
    during adolescence, tuberculosis treated for one year at age 22
    Do you have any health problems or medical conditions related to pregnancy? (If yes)
    Tell me more. None
    5. Have you ever smoked or used tobacco or nicotine products? Y or N? N (if no) skip
    to Q # 9 (if yes) Did you use it during the three months before you became
    pregnant? Y or N ___

     (If yes) are you interested in getting help to quit? Y or N ____


    6. Does anyone smoke inside your home or car? Y or N _____
    7. When was the last time you drank alcohol? ___________
    8. In the last year, has your partner physically threatened or tried to hurt you? Y or N
    (If yes) tell me more ___________________________________
    9. In the last month have you felt down, depressed, or hopeless? Y or N? N
    (If yes) Client needs standardized depression screening tool completed.
    10. Have you ever received mental health services or counseling? Y or N? N

    (If yes) Clients needs clinical assessment.


    11. Who can you count on for help during this pregnancy? Husband

    Who can you talk about stressful things in your life? Husband

    1. Determine the obstetrical history by answering the following questions:


    a. What is the gravidity and parity (GP) of Ms. Newman?

    G2
    P2

    b. What is her obstetrical history of TPAL? Describe what the 4 letter represents on
    Ms. Newman OB history.
    T2
    P0
    A1
    L2
    M0

    T is the number of full-term infants born.

    P is the number of preterm infants born.

    A is the number of miscarriages or therapeutic abortions.

    L is the number of living children.

    M refers to multiple pregnancies.


    c. When is the expected date of delivery (Neagels rule)?
    Last period 6 weeks ago 7-day cycle, cycle 30 to 32 days, duration of flow 7 days, Pregnancy
    occurred after fourth month of new regimen (lets imply as April 2019)
    First day of last menstrual cycle (lets imply its 15th) = “15” + 9 months + 7 days= January 22,
    2020
    d. What is the estimated gestational age in months?
    1 week and 4 days

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