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Sunday, January 18, 2009

Nursing Management Of Preeclampsia

Nursing Care Plan For Preeclampsia

Preeclampsia is a pregnancy specific syndrome of reduced organ perfusion secondary to vasospasm and endothelial activation. It is characterized by hypertension (blood pressure more than 140/90) and proteinuria after 20 weeks’ gestation. Edema is no longer included as a diagnostic criterion for preeclampsia, although it is often present, as it is an expected occurrence in pregnancy and has not shown to be discriminatory.

Description of preeclampsia from some soucer:

From Wikipedia, the free encyclopedia
Preeclampsia is a medical condition where hypertension arises in pregnancy (pregnancy-induced hypertension) in association with significant amounts of protein in the urine. Because pre-eclampsia refers to a set of symptoms rather than any causative factor, it is established that there are many different causes for the syndrome. It also appears likely that there is a substance or substances from the placenta that may cause endothelial dysfunction in the maternal blood vessels of susceptible women.[1] While blood pressure elevation is the most visible sign of the disease, it involves generalized damage to the maternal endothelium and kidneys and liver, with the release of vasopressive factors only secondary to the original damage.

cause of preeclampsia
The cause of preeclampsia is unknown, it is often called the “DISEASE OF THEORIES” because many causes have been proposed, yet none has been well established. than how does preeclampsia occur Experts believe that decreased levels of prostaglandins and a decreased resistance to angiotensin II lead to a generalized arterial vasospasm that then causes endothelial damage. The brain, liver, kidney, and blood are particularly susceptible to multiple dysfunctions. Several risk factors have been identified that may predispose a woman to developing preeclampsia: nulliparity; familial history; multiple gestation; patient history of diabetes mellitus, chronic hypertension, renal disease, trophoblastic disease, and malnutrition.

physical examinatgion of of preeclampsia:
Inspect the patient for pitting edema. Although most pregnant women experience some edema, it has a more abrupt onset in preeclampsia.
Auscultate the patient’s lungs bilaterally to assess for pulmonary edema.
Weigh the patient daily to help estimate fluid retention

signs and symptoms of preeclampsia
The minimum diagnostic criteria for preeclampsia is Blood pressure more 140/90 mm Hg after 20 weeks of gestation.
proteinuria > 300 mg in 24 hours
Other signs and symptoms of preeclampsia support the diagnosis of preeclamsia is:
elevated serum creatinine, lactate dehydrogenase (LDH), alanine aminotransferase (ALT), or aspartate transaminase (AST).
persistent headache.
visual disturbance.
persistentepigastric pain.
increasing Blood pressure.

Nursing Care Plan for Preeclampsia


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