Question

What is the difference between, PIH, mild preeclampsia, severe preeclampsia, and HELLP syndrome?

How can we identify and prevent preeclampsia?

What are patient instructions for self‐management of preeclampsia?

How do we care for a patient with preeclampsia who is receiving magnesium sulfate (include patient and family teaching, administration, maternal and fetal assessments, reportable conditions, and emergency measures)?

Answer 1

A) 1) PIH: PIH is called as pregnancy induced hypertension which is defined as condition of high pressure during pregnancy.This can lead to a comdition called Pre-eclampsia.

2) Mild Pre-eclampsia: Pre-eclampsia is a pregnancy reated disorder that can be dangerous for the mother and the unborn baby.

Mild Pre-eclampsia is defined as when blood pressure is diagnosed

• pregnancy is greater than 20 weeks
• Blood pressure is greater than 140 systolic and 90 diastolic
• Persistent presence of 1+ proteins in the urine dipstick
• No other signs of complication to the mother and the baby.

3) Severe Pre-eclampsia  : Severe Pre-eclampsia is defined as the serious condition in which includes mild preeclampsia alond with other conditions either to the baby or the mother. The following findings is necessary to diagnose severe Preeclampsia.

• Signs of central nervous system eg; headache, blurry vision
• very high blood pressure that is systolic more than 160 and diastolic more than 110
• low platelet count
• protein of more than 5g in 24 hour urine output
• very low urine output
• Signs of respiratory problems
• Severe fetal growth restrictions.

4) HELLP syndrome:  This is a complication of pregnancy which is charecterised by hemolysis, elevated liver enzymes, low platelet count. This occurs usually in the last 3 months of pregnancy.

B) Pre eclampsia is defines as the condition where the blood pressure is high and occurs usually after the 20 weeks gestation.

Pre eclampsia is either mild or severe and can be identified if you have the following symptoms

• Persistent headche
• blurred vision
• Pain in the upper abdomen or shoulder
• Sudden weight gain
• sudden swelling in the face and hands
• difficulty breathing
• decrease in urine output.

prevention:The only way to prevent is by knowing the risk factor and contolling it.

• In the case of high bood pressure see that the blood pressure is well controlled.
• In case of Diabetis control the sugar levels before your pregnancy
• Try to reduce the weight if you are obese
• Strict diet control
• Some providers may recommand Aspirin to be taken throughout the pregnancy

C) Self management of Preeclampsia:

The following points to be kept in mind if you are taking self care management

• Dietary control
• Medications to lower down the blood pressure
• Frequent prenatal visits is important
• Monitor your self and your baby movements.
• Monitor your urine output.

D) Care of patients on Magnesium Sulpahte:

• In severe cases of pre eclampsia the doctors recommend to give magnesium sulphate as an anti seizure medication for severe preeclampsia. tHe health care provider administers intravenously
• The action of Magnesium sulphate is very fast effects and normally given 24 hours before the delivery and patient is continously monitored closely.
• Sometimes treatment can lead to magnesium toxicity with the mothers having symptoms like nausea, vomiting, large drop of blood pressure,confusion, coma, heart attack and the baby may have low muscle tone.
• Any emergency situation can occur if the patinet is in severe condition or the baby condition is detoiriating. Hence managng any emergencies should be kept ready before hand.