1. 34 year old, White, female Delivered 3 rd child yesterday spontaneous vaginal delivery Male, weight=3.8 kg, height =50cm Pregnancy full term, No complications Mother and child progressing well sinus pressure increases when lying down at night dull sinus pressure just under her cheekbones describes as “mild-not that bad really’ small amount of clear nasal discharge catches a cold 2-3 times a year which “often cause pressure in my sinuses” has never experienced nosebleeds “small amount” of red lochia experiencing only “mild” post-partum pains perineum is “slightly tender” breasts feel “full but soft” applies a perineal cold pack every 4-6 hours plans to breast-feed discontinued smoking during both of her previous pregnancies, but returned smoking within 6 months post-partum each time has not smoked since finding out she was pregnant Prior to pregnancy smoked 1 pack per day (X18 years), moderate flow lasting 3-4 days periods are regular every 28-30 days began menstruating at age 12 presently weight 62kg (136pounds). gained 16kg (35pounds) during pregnancy the last couple of weeks found it difficult to obtain a sound sleep because she “just could not find a comfortable position” and had a “bit of a cold” generally a good sleeper (7-8hours a night) has a soft-formed brown BM’s every 1-2 days eats well does not consume alcoholic beverages Recently noted her hair texture is ather “coarse” recently noted that her scalp has been drier than usual no known allergies no skin problems No major health problems She napped throughout the day, but still feels tired. However, there is no impairment in performance of ADL Last night she was awake twice during the night because she was caring for her baby 168 cm tall No chest or leg pain rarely has a headache. Headaches in the past have always been relieved with Tylenol does not remember ever having an ear infection or earaches no hearing problems She sees well with glasses for myopia visits the ophthalmologist every 2 years does not take any medications Takes 1 iron pill daily There has been no hair loss Eats meat, fish or chicken twice a day always eats 6 to 7 fruits or vegetables a day doesn’t skip meals She wears a partial upper denture, which she soaks each night in Polident No chest or leg pain She always wears a seat belt has never experienced dizziness, vertigo, or syncope does not have varicose veins or problems with circulation, leg infection or ulcers All immediate family members are healthy lives with her husband and 2 children (Ronda aged 8 and John aged 4). She enjoys cooking and rarely eats out She now eats approximately 10 servings of grain products per day eats whole grain cereals to suppress her appetite makes sure that she drinks more milk (around 4 glasses/day) Since delivery, she has a “ravenous appetite drinks 2-3 cups/ glasses of juice or tea a day but doesn’t like water Their home is a single family dwelling in a safe neighbourhood her relationship with her husband (aged 42) is “very close” with no marital problems Her husband manages a large business has been a stay-at-home mother since birth of her second child graduated high school, and completed an Early Childhood Educator’s diploma they are financially secure Both paternal grandparents died at the age of 76 from complications related to IDDM she has one sister (age 38) who has a history of NIDDM Her father is 60 years old and has hypertension Her mother is 56 years old has no medical problems Her parents live within walking distance She hopes to remain a non-smoker for life She says that she was “pretty stressed” last year upon the sudden death of a close friend. She found that talking to her husband, parents, and her faith/ prayer helped her get through this episode in her life She feels good about herself She takes pride in her role as a mother and housewife she had an appendectomy at age 12 she has had the usual childhood illnesses like chicken pox, measles and Mumps her immunizations are up to date Ms Reid