NUR 2513 Maternal Child Nursing Preeclampsia Case Study

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Encourage Mrs. Smith to come into the hospital. On evaluation Mrs. Smith’ vitals are: BP: 148/92 P: 68 R: 16 T: 37.1 Pain: 4/10 for headache Reflexes: 3+ SVE: fingertip/thick/-3 Mrs. Smith ... states baby has been active, and her contractions have been every 5-8 minutes apart lasting two minutes or so. Monitors are applied to Mrs. Smith. Fetal heartrate is 125 bpm with accelerations and no decelerations. Irritability is noted with occasional contractions that palpate mild for intensity. What are some other questions the triage nurse should ask Mrs. Smith? When did the contractions start? Are you currently experiencing headaches, blurred vision, any lightheadedness? Are you feeling the baby move/kick counts completed? Have you taken any medication for the headaches and other symptoms? Do you have a history of HTN? Are you on any medications to control your HTN? When was the last time you ate/drank anything? How often are you eating/drinking and how much? How is your pain? Has your water broken? Mrs. Smith states that her bag of water is still intact. Her headache started two days ago and is not getting better with Tylenol, oral hydration, or rest. She states she only notices seeing stars or flashes with her vision that are constant for the last few hours. She has not been dizzy. Mrs. Smith denies epigastric pain, nausea or vomiting. She states her ankles and feet are a little more swollen than normal, but she has not been getting daily weights. She states that she has been drinking more water to see if her headaches are from dehydration, but she hasn’t noticed an increase in urine output. The triage nurse calls the on-call obstetrician, Dr. White, and fills him in on the patient. Dr. White would like the preeclampsia lab work up done. What labs are consistent with the preeclampsia lab work up? Why are these labs consistent with the preeclampsia lab work up? The doctor may order a CBC to check platelets and other blood counts, a liver function tests, kidney function test to check the body’s clotting ability and a urinalysis to check for protein. An ultrasound may be done to check the baby’s growth and a fetal stress test may be done to monitor the baby’s heart rate during the mother’s contractions. Mrs. Smith lab results came back normal except for her protein/creatine level was 0.8. Mrs. Smith’s blood pressures have been taken every 15 minutes while in triage. Her blood pressures have been: 156/89, 149/87, 152/91, 152/89 and 148/94. What do you expect Dr. White to do with the information presented? What medication will the patient be started on? Dr. White may start Mrs. Smith on antihypertensives to help control her blood pressure, such as labetalol, or magnesium sulfate. A corticosteroid may be ordered to help improve liver and platelet function and prolong the pregnancy. He may recommend Mrs. Smith be placed on bed rest or be admitted to the hospital for further evaluation. If her blood pressure continues to rise and be uncontrolled, she may be induced or have a c-section scheduled [Show More]

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