596552
Descrição
Mapa Mental por holly.stroud, atualizado more than 1 year ago
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Criado por holly.stroud
mais de 10 anos atrás
|
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Pregnancy
induced
hypertension
- Patient: Mrs. Smith, 31 years of age,
36 weeks gestation, G2 P0 A1.
Admitted due to patient feeling
lightheaded and epigastric pain.
- Risk of development of
preeclampsia r/t high blood
pressure above 140/90, and preexisting high blood pressure prior to pregnancy.
- Risk of placental
growth insufficiency
due to the negative
effects of severe
preeclampsia and smoking combined
- May also lead to
intrauterine growth
restriction. This is due to
insufficient blood supply to
allow placental and fetal
growth and decelopment
- External fetal monitoring
and ultrasound need to
monitor current fetal
heart and activity level
and to be able to
appropriately see fetal
and placental growth and
development.
- External fetal monitoring
and ultrasound need to
monitor current fetal
heart and activity level
and to be able to
appropriately see fetal
and placental growth and
development.
- May also lead to
intrauterine growth
restriction. This is due to
insufficient blood supply to
allow placental and fetal
growth and decelopment
- Continually monitor patients blood pressure. If blood
pressure continues to be elevated and patient is
diagnosed as being preeclamptic, administer
- Risk of developing
HEELP syndrome.
- Induction of
labour when safe
for patient if
diagnosed with
preeclampsia.
- Being oxytocin
6 units in 2/3
&1/3 at a rate
of 2ml
- Being oxytocin
6 units in 2/3
&1/3 at a rate
of 2ml
- Risk of placental
growth insufficiency
due to the negative
effects of severe
preeclampsia and smoking combined
- Risk of
increased stress r/t
potential of
preterm labour
and/or loss of
newborn
- Spontaneous loss of
previous pregnancy at
18 weeks gestation.
Why did this occur?
Did this cause
pyschosocial effects
on the patient.
- Engage in fetal stress test and place patient on continuious
fetal heart monitoring. This will ensure that the fetus is not
in distress and appears to be happy and healthy. Further
ultrasound testing may be needed to look at fetal placement,
fetal growth and so forth.
- Multidisciplinary approach with social
work to add support to the family as the
last pregnancy was not desirable.
- Engage in fetal stress test and place patient on continuious
fetal heart monitoring. This will ensure that the fetus is not
in distress and appears to be happy and healthy. Further
ultrasound testing may be needed to look at fetal placement,
fetal growth and so forth.
- Spontaneous loss of
previous pregnancy at
18 weeks gestation.
Why did this occur?
Did this cause
pyschosocial effects
on the patient.
- Risk of a cardiovascular
accident or seizure activity r/t the effects of
hypertension and smoking
- Ensure magnesium sulfate is initated
24 hours prior to delivery and
continues during delivery to ensure
the patient does not experience
seizure activity during the labour
process.
- Patient feeling lightheaded puts
heavier need on closely
monitoring patient for seizure
activity. Even though this may be
caused by other factors such as
hydration, it may also be solely
from preeclampsia
- Take on a holistic approach to nursing interventions.
This means continually checking blood pressure and
other needed diagnostic testing as well as continually
asking the patient of their well-being. Also ensure
patient teaching on seizure and stroke signs and symptoms (visual
changes, nausea, urinary incontinence, headache, etc).
- Is the patient in
pain? Offer
epidural for
comfort
- Ensure magnesium sulfate is initated
24 hours prior to delivery and
continues during delivery to ensure
the patient does not experience
seizure activity during the labour
process.
- History of pregnancy: patient states that this
pregnancy seemed normal, no reports of high
blood pressure up to this point. Although the
patient explained that she experienced
moderate high blood pressure previous to
pregnancy. Stress is present during this
pregnancy due to the fear of misscarrying
again and fetal overall health. No alcohol use.
Smokes occasionally. Only medications are
prenatal vitamins.
- Objective Values: BP- 142/94, temp- 37.2,
resp- 18, urinanalysis- ph 6.050, protien-
+++, all other values were negative. Blood
tests show increase in uric acid, increase
in hemocrit, slight decrease in platelet
count, increase in pt/PTT, increase in
creatinine, increase in AST and ALT,
normal total billirubin.
- Repeat testing every 6 hours
- Repeat testing every 6 hours
- Allergies: Penicillin = Rash.
- GBS negative, HIV negative.
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