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PreeclampsiaCase StudyMeet the Client: Jennie SmithJennie Smith is a 15-year-old female client who is a gravida 1, para 0 at 36 weeks gestation by both estimate date of birth and ultrasound. She began prenatal care at 10 weeks gestation and has had an uneventful pregnancy except for mild pedal edema that developed 1 week ago. Her 17-year-old boyfriend has been involved throughout the pregnancyWhich factors add to the risk of this patient developing preeclampsia?Molar pregnancyFamily historyHistory of headachesLow socioeconomic statusAgeNulliparity2, 5 3What is the pathophysiology behind Jeannies headaches?Cerebral edemaIncreased perfusion to the brainSevere anxietyRetinal spasms14Jennie has generalized edema. Her family asks for a fluid pill. Should this patient receive a diuretic? Why or why not?The patient is hypovolemic but fluid has shifted into interstitial space due to protein leak5The nurse starts an IV and hangs D5RL with 20 units of Pitocin. The order reads administer 2 mu/min. What is the rate you key in on the pump?First change units to mu =20,00020,000 mu_______ x 2 mu1000ml _____

6 ml6While waiting on lab results what is the nursing priority? Teach Jennie the rationale for bed restMonitor for signs of dehydrationEducate about diet restrictionsObserve for CNS changes

47What labs would be seen in HELLP syndrome (select all that apply)Increased hematocritNormal PTTLow plateletsElevated liver enzymesElevated haptoglobin

3,4,58Which assessment finding would indicate magnesium toxicity?Complaints of chills and feverRR < 12/bpm and absent DTRs.Mild sedationUrine output of 32 ml/hr.29The nurse notes on the fetal strip a decrease in HR with minimal variability. What is the cause?Cord compressionFetus is descending into the pelvisThe moms HTN has caused fetal distressThe MgSO4 level in mom and fetus is the same.4 acts as a mild sedative10Jennie has eclamptic seizure. When the nurse enters the room what takes priority?Monitor fetus for nonreassuring patternsTurn patient on her side with pillow behind backMake note of time of seizureSuction mouth 211The nurse watches the Fetal monitor after the seizure. At the peak of contractions, the HR drops to 117 bpm then returns to baseline of 130 beats after 15 seconds. She also notes minimal variability.What change has occurred?TachycardiaVariable accelerationsLate decelerationsTransient bradycardia312Jennie is on MgSO2. What medication should be available for use?DilantinLebatololPotassium chlorideCalcium gluconate413The baby is born. The nurse anticipates and prepares for what complication related to the mom receiving mag sulfate?Hyperflexia and increased respirationsHyporeflexia and irregular respirationsHyporeflexia and decreased respirationsHyperflexia and irregular respirations

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