Nursing Care for Pregnancy Complications Quiz

Nursing Care of a Family Experiencing a Sudden Pregnancy Complication

• Symptoms of overdose include reduced consciousness, decreased urine output, decreased tendon reflexes, and depressed RR.

Supportive Care

• Support bed rest to enforce hospitalization and close observation.
• Restrict visitors to support people, such as the husband.
• Raise padded side rails to prevent injury.
• Dimly lit room is necessary.

Monitoring Maternal Well-being

• Monitor blood pressure.
• Obtain blood studies as ordered.
• Obtain daily hematocrit levels as ordered, which will rise (>40%) if increased fluid is leaving the bloodstream for interstitial tissue (edema).
• Assess weight daily at the same time.
• Indwelling catheter may be inserted.

Monitoring Fetal Well-being

• External fetal monitor is attached.
• O2 administration may be necessary to maintain adequate fetal oxygenation.

Nutritional Support

• Moderate to high protein diet.
• Moderate sodium in the diet.
• IVF line should be initiated and maintained to serve as an emergency route for drug administration.

Medication Administration

• Hydralazine (Apresoline) to reduce hypertension, administered via IV infusion pump (5-10 mg/IV).
• Hydralazine lowers blood pressure by peripheral dilatation.
• Assess pulse and BP before and after administration.
• Diastolic should not be lowered below 80-90 mmHg to prevent inadequate placental perfusion.

Mild Preeclampsia

• Symptoms include:
  • Systolic BP > 30 mmHg above pregnancy level.
  • Diastolic > 15 mmHg above pregnancy level.
  • Proteinuria +1 to +2.
  • Weight gain: 2 lbs/wk in 2nd trimester, 1 lb/wk in 3rd trimester.

Severe Preeclampsia

• Symptoms include:
  • BP > 140/90 mmHg.
  • Mild edema in upper extremities or face.
  • Cerebral edema.
  • Proteinuria: 3+ to 4+ on a random sample.
  • Oliguria: 500 ml or less in 24 hrs.
  • Pulmonary involvement: shortness of breath.
  • Hepatic dysfunction.
  • Epigastric pain due to ischemia in the pancreas and liver.
  • Visual disturbances: blurred vision or seeing spots.

Antiplatelet Therapy

• Mild antiplatelet agent, such as low-dose aspirin (81 mg), may prevent or delay the development of preeclampsia.

Bleeding Complications

• Common causes of bleeding according to trimester:
  • 1st Trimester: Spontaneous miscarriage, ectopic pregnancy.
  • 2nd Trimester: Gestational trophoblastic disease, premature cervical dilatation.
  • 3rd Trimester: Placenta previa, abruptio placentae, preterm labor, disseminated intravascular coagulation (DIC), abdominal pregnancy.

Nursing Diagnosis and Interventions

• Nursing Diagnosis: Risk for deficient fluid volume related to bleeding during pregnancy.
• Outcome Evaluation: Patient's blood pressure is maintained at above 100/60 mmHg, pulse rate is below 100 beats/min, minimal bleeding is apparent, fetal heart rate (FHR) is maintained at 120-160 beats/min with adequate short and long-term variability, and maternal urine output is greater than 30 ml/hr.

Goals of Therapy for Hypovolemic Shock

• Restoring blood volume.
• Halting the source of hemorrhage as quickly as possible.

Test your knowledge on providing nursing care for families experiencing sudden pregnancy complications like mild and severe preeclampsia. Topics include monitoring hCG levels, blood pressure changes, proteinuria, and weight gain during different trimesters.