University:
Felician University
Course:
NURS 235 | Global Issues In Health And Social Policy
Academic year:

2019
Views:

463

Pages:

2
Author:

Calvin S

A 38-year-old female is 36 weeks pregnant and arrives at labor and delivery for a headache that won’t go away with acetaminophen. The nurse gets the patient’s vitals. What should the RN be asking the client? - The nurse should be asking the patient if she has any blurred vision, if she has had any floaters, nausea, or vomiting. The nurse should also be asking if she has had any sudden weight gain or and swelling in the hands and face and or her feet. Also I would also ask the patient if she has had any abdominal pain. What other assessments should the nurse do at this point? - The nurse can assess the body as she is talking to see if she can see any visual edema. You also should ask the patient if she has this issue before. You can also get some past and present medical history. Possibly even family history. I think you could even hook her up to a fetal monitor to make sure the baby is ok. The nurse notes that the patient’s blood pressure is 156/98 mm hg and asks the patient “have you had any blurred vision, floaters or changes to that? Any sudden swelling, sudden weight gain? -The patient responds, “yes, I keep seeing floaters and have even thrown up from it. I do have some swelling and my upper abdomen has really been hurting. My head is really hurting.- The nurse goes to call the doctor. Nurse to Dr. “Hey Dr. Smith your patient, Maria Evans is here with some symptoms of preeclampsia. She has a BP of 156/98 mm hg, epigastric pain, bad headache, and some vision changes. What do you expect the doctor to order? - I would expect the doctor to order a urine to see if there is any protein in the urine. Blood work to test for full blood count, platelets, any kidney issues. Maybe also you can do a Non stress test or biophysical profile. You could also do a fetal ultrasound. The nurse calls for help and nurses enter the room. They call the patient’s name, get fetal heart tones, apply oxygen, protect the patient. A nurse calls the doctor again and explains the patient is having a seizure. What nursing actions have you already implemented? And why? - The nurse has lowered the head of the bed to keep the patient safe. There is also padding on the bed rails again for the patients safety and to try to prevent any injury. There is a nasal cannula and or mask to give the patient 02. Also suction equipment is ready to promote airway clearance. What is pathologically happening to the patient? - Pathologically the patient is becoming eclamptic. Eclampsia usually follows preeclampsia. Which is usually due to high blood pressure and protein in the urine. When your preeclampsia gets worse it affects your brain function which causes seizure which then leads to eclampsia. What do you want the Health Care Provider to order? - You would want the healthcare provider to order something to prevent the seizures (an Anticonvulsant) like magnesium sulfate. As well as something to treat the high blood pressure such as Lebetolol.

Case Study Preeclampsia

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