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.