Nursing Care for Mother with Pregnancy Induced Hypertension

Abstract

Background: Hypertension during pregnancy is a serious complication in obstetrics that causes an increase in the amount of disabled and deceased. A nurse who provides nursing care must have knowledge and competencies for patients safety, continually notice the patient’s changing symptoms and a nurse must practice nursing process in the most technically correct ways, such as observation,analysis and provide nursing care effectively and correctly in practical terms and nursing care. These skills reduce complication and dangerous signs to the pregnant women and infant. This study shows a comparison of nursing care for mother with Pregnancy Induced Hypertension 2 cases.

Results of study : (Case 1) Thai female, Primigravida, 38 years old, coming to the hospital with GA 38⁺² wks. with labor pain with hypertension BP 161/112 mmHg. Doctors diagnosed severe PIH and admitted to Chonburi Hospital from June 12, 2017 to June 14, 2017. In attend room, the range of blood pressure were 161/112 mmHg. to 187/119 mmHg. Then, the doctor ordered 50% MgSO₄ 5 gm + 0.9% NaCl 100 ml IV drip in 30 min then 50% MgSO₄ 20 gm + 0.9% NaCl 1,000 ml IV drip 50 ml /hr. Pregnant woman received electronic fetal monitoring and the range of fetal heart rate (FHR) 130-140/min. Pregnant woman with a MgSO₄ Infusion should be closely monitored by nurse. Nursing care of monitoring pregnant woman with a MgSO₄ Infusion were preventing leakage from the blood vessels to the surrounding tissue, monitoring blood pressure, monitoring FHR, and observing side effect of MgSO₄ .  In this case, the blood pressure was reduced after receiving MgSO₄ and no side effect of MgSO₄. Finally, this case had vaginal delivery with vacuum extraction and discharge June 14, 2017.

Both case study 1 and 2 had severe pregnancy induce hypertension. Differenlty, in case study 2, patient was preterm pregnancy and symptoms of the disease developing to Hemolytic anemia Elevated Liver enzyme Low Platelet count (HELLP syndrome). Therefore, More violent In addition to preventing seizures and postpartum hemorrahge, it was necessary to give steroid for pregnant woman to stimulate the surfactant in infant’ slungs before terminate labor with cesarean section. After nursing care was found pregnant woman not seizures, Postpartum hamorraghe or severe harm until death or disability. This study shows that nurses play an important role in caring the first assessment, planning, nursing implementation, evaluation by evident base practice. This can be used as the guideline for the caring Effectively pregnancy induce hypertension.Keywords : Nursing care pregnancy, Induced hypertensio