Nursing care for Severe Pregnancy-induce hypertension : Case study

Abstract

Case study of Thai adolescents, 16 years old, first pregnancy, 28 weeks gestation, She was admitted with general swelling, headache, blurred vision, Proteinnuria +3, BP 169 /119. Pregnant, check the belly level 3/4 more than navel, no labour pain, Baby Heart sounds left 140 times/minute. The cervix does not open, body swelling and DTR + 3. However she was admitted in the hospital for controlling high blood pressure by anticonvulsants and steroids to stimulating lung development of fetus in utero, then we could control blood pressure. Finally the obstetrician considered to terminate pregnancy by Caesarean section procedure; fetal birth weight 1,574 grams and she should be treated in time. There are clinical risk from laboratory testing result abnormally high magnesium not related symptom patient but that not reaching dangerous for the patient by timely review and revise immediately. Throughout the treatment no convulsion.

In the 4th day , the patient was improved have family planning with implanon NXT through discharge after that, home medication is antihypertensive and anticonvulsant for one week, allowed follow up by monitoring blood pressure to normotension, coordinate intensive infant ward for lead patient to care newborn grow with additional with according to the criteria.

Nurses require the knowledge, ability, and expertise to assess early warning indication and monitoring laboratory result, then can assessment signs and symptoms of patients that has changed from normal levels. Nevertheless, we should have a preparation of the nursing care team and instrument for helping immediately to decrease the risk from dangerous situation, mortality of maternal to fetal and there are no complications in the mother and baby throughout the treatment, no maternal complications, no epilepsy treatment.

From this case study in which teenage pregnancy with high blood pressure during pregnancy. There is a risk of seizures and treat with anticonvulsant drugs. The system should provide continuity of care for the prevention of high blood pressure in the future.