Eclampsia: 1. In the chart below, contrast the physiologic changes of a normal pregnancy with those of a patient with pregnancy induced hypertension. Physiologic Change Normal Pregnancy Pregnancy Induced Hypertension Peripheral Vascular Resistance Role of Thromboxane Role of Prostacyclin Maternal Vasodialtion Plasma Volume Nitric oxide Renal perfusion Glomerular filtration rate Resistance to angiotensin II Edema Coagulability 2. Identify maternal risks from PIH, including the HELLP syndrome 3.
Compare the signs and symptoms of mild and severe PIH Mild PIHSevere PIH 4. Outline the prenatal medical management of the patient with mild PIH and severe PIH: Mild PIHSevere PIH 5. Define eclampsia: 6. Describe the home care of the PIH patient: 7. Describe the hospital care of the PIH patient: 8. How does the hospital care differ if the patient is a preterm gestation? 9. Describe the use of Magnesium Sulfate in the care of the patient with severe PIH: A. Action B. Route and Administration C. Side Effects D. Nursing Actions 10.
Describe nursing assessment measures important in the care of the patient with PIH: A. Blood pressure B. Pulse and respiration C. FHR D. Urinary output E. Urinary protein F. Edema G. Daily weights H. Pulmonary edema I. Deep tendon reflexes J. Headache K. Visual disturbances L. Epigastric pain M. Level of consciousness PIH CASE STUDY T. M. Is a 27 year old Gravida 1, Para 0, who is admitted to the labor and delivery unit at 38 weeks gestation. At the time of admission, vital signs are: Temperature 98, Pulse 80, Respirations 16, Blood pressure 160/100, FHR 132/min.
Her cervix is 2 cm dilated and 65% effaced. She is having contractions lasting 35 seconds every 3-4 minutes. Station is -3, vertex presentation. A dip stick is done on her urine and shows negative glucose and ketones, and 2+ protein. Physical exam findings include +1 edema and +3 deep tendon reflexes. Significant prenatal history includes elevated blood pressure of 2 weeks duration before admission. T. M. complains of a frontal headache on admission. She denies epigastric pain. 1.
Underline the Significant Data in the above situation and identify how this data related to the diagnosis of PIH. 2. Identify priority nursing diagnoses based on this data and identify specific interventions. Nursing Diagnosis Interventions 3. Two hours after admission, magnesium sulfate is started by IV infusion. Describe the pharmacology of magnesium sulfate, including action, rationale for use in PIH, side effects, dangers, contraindications. 4. Discuss the nursing care for T. M. while she is receiving magnesium sulfate.