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Republic of the Philippines

PAMANTASAN NG LUNGSOD NG MAYINILA


(University of the City of Manila)
Intramuros, Manila

HIGH RISK PREGNANCY

BIOGRAPHICAL DATA

NAME: Jenny Dela Cruz AGE: 16 years old


BLOOD TYPE: Di ko alam. BIRTHDATE: September 9, 2000
BIRTHPLACE: Manila RELIGION: Roman Catholic
LANGUAGE SPOKEN: Tagalog NATIONALITY: Filipino
ADDRESS: 723 Josefina St. Sampaloc, Manila OCCUPATION: Housewife
PhilHealth MEMBER: No EDUCATION LEVEL: High School
SOURCE OF INCOME: Family DATE INTERVIEWED: June 19, 2017

HISTORY OF PAST PREGNANCY

Weight before pregnancy: 40 Kg. Last Menstrual Period: Oct. 13, 2016
Woman’s attitude over pregnancy: Natatakot lang ako.
No. of pregnancies: Unang beses ko pa lang to No. of abortions: None
No. of living children: None

GYNECOLOGIC HISTORY

Last pap smear: Wala. Last ultrasound: May 29, 2017


Previous surgeries: Wala Age of Menarche: Di ko na maalala
Interval of menstruation: Tuwing 1st week ng buwan Duration of Menstruation: Iba-iba eh
History of dysmenorrhea: Wala naman. Do you have dentures? Wala.
Hours of sleep: 8-10 hours yung tulog ko. Is your gums or teeth aching?: Hinde.
Childhood diseases: Bulutong po.

PHYSICAL ASSESSMENT

Skin Color: Brown, normal


Hair: Long hair, brown
Nails: Short, normal
Head shape/Skull: Oblong, may lump ng konti.
Sleeping Habits: Nagse-cellphone ako bago matulog.
Questions:

1. How many months have you been pregnant? Do you know if it’s a girl or boy already?
Answer:
Walong buwan na po akong buntis, at babae daw po yung baby ko.

2. How is your pregnancy going? For this pregnancy, do you have any:
-Nausea or vomiting
-heartburn
-constipation
Answer:
Frustrated at kinakabahan lang po ako kasi unang baby ko to at bata pa po ako, pero wala
naman po akong nararamdamang heartburn at constipation, Hilo at suka lang naman yung
sakin.

3. Have you seen a medical provider? If yes, when did you first see your medical provider?
Answer:
Oo, nung April 12.

4. What health or medical concerns, if any, do you or your medical provider have about your
pregnancy, such as high blood pressure anemia or gestational diabetes?
Answer:
UTI daw po, natatakot nga po ako na baka mahawa yung baby ko.

5. How many times have you been pregnant for the past two years?
Answer:
Unang pagbubuntis ko pa nga lang po.

6. Do you have any medical problems or health condition that is not related to your pregnancy?
Answer:
Wala namang po akong ibang sakit bukod sa UTI.

7. Have you had any major surgeries, serious injuries or burns before?
Answer:
Wala naman po.

8. Are you taking any medications? What kind and for what?
Answer:
Wala din po.

9. Do you take prenatal vitamins?


Answer:
Ferrous Sulphate

10. Do you smoke? Or does anyone smoke inside your home smoke?
Answer:
Ay opo naninigarilyo po ako pati po yung asawa ko.
11. Do you drink alcohol? If yes, when was the last time you drank alcohol?
Answer:
No. Hinde po ako umiinom.

12. Lots of women feels sad or depressed before or after pregnancy. Have you felt sad or
depressed recently?
Answer:
Opo, medyo stress po ako dahil po sa family ko, di naman maiiwasan yun lalo’t na bata pa ako at
sa kanila din kami umaasa.

13. Do you eat junkfood, chips, etc.?


Answer:
Minsan lang po ako kumain syempre masama din sa baby ko yun.

14. How has your appetite been? Are there foods you limit or avoid for any reason, including food
allergies?
Answer:
Magana naman akong kumain at wala naman akong bawal kainin at mga allergy na yun.