Propose a differential diagnosis with a minimum of 3 possible
conditions or diseases. You will prioritize these diagnoses and explain which you would recommend.
To prepare:
• Review the Learning Resources for this week as well as Weeks 5 and 6 and specifically review the clinical
guideline resources specific to your assigned case study.
• Use the Focused SOAP Note Template found in the Learning Resources to support Discussion.
Case Study: Hypertension in Pregnancy
Kita Brown is a 36-year-old G1 P0 black female presenting to her local urgent care with headache and stating
her mother took her blood pressure and it was a “little higher than it should be”. Kita has had an unremarkable
pregnancy, which was conceived thru IVF. She is currently 30 5/7 weeks pregnant and relates she has had no
problem with her pregnancy. She only takes prenatal vitamins, and relates she was on hctz prior to pregnancy
for borderline BP but stopped it when she underwent IVF and her BP has remained “pretty normal”. Sher
relates she was prescribed po labetalol but did not take it regularly as she didn’t want to take anything that
might hurt the baby.
Her initial prenatal screening, including initial labs, and third trimester CBC and glucose testing have been
normal. She additionally at her 1st prenatal visit had baseline PIH (pregnancy induced hypertension/preeclampsia) due to her history of hypertension which were normal including a protein to creatine ratio.
Upon intake at the urgent care the notes relate she appears in no apparent distress, and she has reported fetal
movement within the past hour. She denies, any other symptoms including epigastric pain, vision changes or
nausea. She states fetal movement has been normal, and denies leaking fluid, vaginal bleeding, or
contractions. She relates slight swelling and her weight gain date has been 17 lbs. Current BMI is 25.1. BP is
162/90, pulse 82, respirations 16 and unlabored, temperature 98.2 orally. Kita was transferred to the
emergency room due to her complaints and her gestational age.
Upon arrival to the emergency room 30 minutes later her repeat BP was 166/ 88. It was retaken 15 minutes
later and was 162/92. All blood pressures were confirmed with a manual cuff. She had no additional
complaints.
Based on your assigned case study, post the following:
• Provide a differential diagnosis (dx) with a minimum of 3 possible conditions or diseases.
• Define what you believe is the most important diagnosis. Be sure to include the first priority in conducting your
assessment.
• Explain which diagnostic tests and treatment options you would recommend for your patient and explain your
reasoning.
• What interventions would you implement?
• What further information would you need?