Problem
Perfusion Case Study: Pre-Eclampsia
Ginny Sims is a 36-year-old primigravida at 34 weeks' gestation. She is married to Paul, whose job as a buyer for a major department store chain requires a great deal of travel. They had plans to have children when they first married, but they had trouble conceiving. When she began feeling very tired and nauseated in the mornings, she decided she was in early menopause because her period was late.
As fatigue continued to impede her ability to concentrate at work, Mrs. Sims finally made an appointment with her OB/GYN and found out she was pregnant. She and her husband are thrilled and can't wait to greet their newborn.
Mrs. Sims is seeing the nurse practitioner today for her routine prenatal examination. The nurse takes Mrs. Sims's BP, and it is 140/92 mmHg, increased from her baseline of 110/70 mmHg. Mrs. Sims's ankles are slightly swollen, and she admits to an occasional recurrent nagging headache. Her urine dip shows 2+ protein.
Task
A. What further assessments would you perform to support the diagnosis of preeclampsia?
B. What teaching will you provide before sending Mrs. Sims home from the office?
C. What assessment findings would indicate worsening preeclampsia in this patient?
D. What do we need to keep in mind in carding for this patient post-delivery?