Question

Use Active Learning Template: Diagnostic Procedure PREECLAMPSIA.

Answer 1

Diagnosis

• Deficient fluid volume maybe related to osmotic pressure possibly evidenced by edema formation.
• Decreased cardiac output maybe related to hypovolemia possibly evidenced by change in blood pressure.
• Impaired tissue perfusion maybe related to maternal hypovolemia.
• Risk for maternal injury maybe related to tissue edema possibly evidenced by presence of signs/symptoms establishes an actual diagnosis.

Pathophysiology related to client problem

Overproduction of autoimmun proteins by the placenta causes cellular dysfunction .Spiral arteries fail to remodel or accomodate growing placenta,decreased placental perfusion constriction of vascular network with increased volume of pregnanc increased vascular permeability abnormal coagulation changes causes ischemia of target organs.

Health promotion and disease prevention

• Use little salt
• Drink 6-8 glases of water a day.
• Dont eat a lo of fried foods.
• Get enough rest
• excercise.

Risk factors

• Hypertension
• Renal disease
• Multiple gestation
• Maternal age over 40
• Prior pre eclampsia.

Lab tests

• CBC
• Liver enzymes
• LDH
• Serum uric acid
• Urine protein
• Serum Creatinine
• clotting studies
• 24 hour urine
• urine dipstick.

Expected Findings

• Proteinuria
• Headaches
• changes in vision
• nausea or vomiting
• decreased urine output
• impaired liver function
• shortness of breath.

Diagnostic Findings

Inorder to diagnose pre eclampsia,first you have to check blood pressure and one or more of the following complications after the 20th week of pregnancy

• Protein in urine
• low platelet count
• impaired liver function
• kidney problems
• fluid in the lungs
• new-onset headaches or visual disturbances.

Nursing care

• Check BP every 4 hours.
• Monitor daily wait
• fetal monitoring
• Deep tendon reflexes.
• Intake and output
• Dipstick urine for protein
• low sodium diet.
• bedrest
• daily labs
• kidney function

Therapeutic Procedures

• Magnesium sulphate to prevent seizures and contril BP.
• Steroid injection to promote fetal lung maturity
• Reflex test and Sonography.
• Delivery is the only treatment that will make it go away.

Medicines

• Magnesium sulphate,Hydralizine ,Nifedipine

Client education

• Health care providers should discuss with the women who have preeclampsia that there is an increased risk of cardiovascular disease later in life,including during the premenopausal period.
• Advice should be given on lifestyle modifications and management of lipid disorders,diabetes and hypertension can help to reduce the risk of cardiovascular problems.

Complications

• red cell break down
• low platelet count
• impaired liver function
• kidney problems
• swelling
• shortness of breath.

Safety considerations

• Aspirin,calcium supplementation and treatment of prior hypertension.