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A 38 y.o. mother is in active labor. On assessment, the nurse obtains the following data:...

A 38 y.o. mother is in active labor. On assessment, the nurse obtains the following data: BP 200/140; T 98.9, P 90, R 21, urine protein 3+. The mother complains of dizziness and blurred vision.

1. Based on these findings, which data will the nurse report to the RN? Include rationales.

2. What condition(s) do you suspect this woman is developing?

3. What orders will you anticipate the physician ordering? Include rationales.

4. What nursing interventions will your incorporate into your plan of care? Include rationales.

Solutions

Expert Solution

Question 1.the nurse should report the blood pressure reading of 200/140mmhg,urine protein of 3+, and the mothers complaints of dizziness and blurred vision which are significant findings.

Question 2. The women is developing pre-eclampsia a complication of pregnancy induced hypertension. If not treated she will end up in eclampsia. Pre eclampsia is defined as aSBP more than 140 and DBPmore than 90 in two readings atleast 4 hours apart in a previously normatensive person, a glucose dip stick of more 1plus, Elevated liver enzymes. The major signs and symptoms include headache, blurred vision, Edema, Dyspnea, and right upper quadrant pain.

Question 3.

The first line treatment for pre-eclampsia is MgSo4 infusion to treat seizures.slow iv of 4 gm over 5 minutes and followed by infusion.

Antihypertensive therapy during pregnancy.

Beta blockers(inhibits action of catecholamines on the adrenoreceptors) , alpha and beta locker (labetalol), methyl dopa(acts centrally to produce a decrease in vascular resistance) , nifedipine(calcium channel blocker), hydralazine (direct acting vasodilator).

If the fetal status is not reassuring immediately shift for a lower segment cesarean section or if the fetal status is good speed up the second stage by instrumental deliveries.

Nursing interventions.

Risk for eclampsia related to pre eclampsia as evidenced by hypertension, proteinuria and blurred vision.

Monitor blood pressure and urine proteins _to provide objective data.

Administer MgSo4 and antihypertensives_to prevent pre eclampsia and to treat hypertension.

Advice her to take rest

Monitor intake and output chart.

Nightingale answered 2 years ago
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