Nursing care plan for patient with gestational hypertension
Answers
Answer:
Explanation:
Monitor vital signs, particularly blood pressure
Blood pressure may fluctuate and spike quickly; monitor for changes and elevations
Assess for edema; note location and determine degree of pitting
Some swelling is normal in pregnancy, but pitting edema is different and can be a significant sign of decreased cardiac output.
Weigh patient regularly
Sudden increase in weight indicates fluid retention and may signify progression of disease and impaired renal function
Auscultate heart and lungs; note rate and rhythm; administer oxygen as necessary
Monitor for signs of fluid overload and pulmonary edema which puts strain on the cardiopulmonary system
Listen for crackles and note presence of dyspnea
Oxygen supplementation may be given to relieve dyspnea and improve maternal-fetal oxygenation and tissue perfusion
Administer IV fluids and medications as appropriate
Antihypertensives(hydralazine) may help decrease diastolic pressure and increase blood flow to vital organs
Antiepileptic drugs and magnesium sulfate for seizures
Monitor fetal heart rate
Observe for signs and symptoms of fetal distress due to maternal blood pressure, decreased placental blood flow and lack of oxygenation
Assess for vision disturbances and cognitive function
Preeclampsia may progress over time or suddenly to eclampsia and result in seizures.
Note any changes in mentation or vision as an exacerbation of preeclampsia.
Monitor labs and diagnostic test results
Observe for proteinuria, blood glucose level, elevated liver enzymes and decreased renal function.
Provide nutrition and lifestyle education
Low sodium diet to help reduce edema
Bedrest and elevation of the feet to reduce blood pressure
Encourage patient to rest on left side to prevent compression of vena cava