case study pre-eclampsia

Holy Angel UniversityAngeles City

College of Nursing

Pre-Eclampsia

December 05, 2008

I. INTRODUCTION

Description of the Disease

Preeclampsia, also referred to as toxemia, is a condition that pregnant women can

get. It is marked by high blood pressure accompanied with a high level of protein in the

urine. Women with preeclampsia will often also have swelling in the feet, legs, and

hands. Preeclampsia, when present, usually appears during the second half of pregnancy,

generally in the latter part of the second or in the third trimesters, although it can occur

earlier.

In addition symptoms of preeclampsia can include:

Rapid weight gain caused by a significant increase in bodily fluid

Abdominal pain

Severe headaches

A change in reflexes

Reduced output of urine or no urine

Dizziness

Excessive vomiting and nausea

The exact causes of preeclampsia are not known, although some researchers

suspect poor nutrition, high body fat, or insufficient blood flow to the uterus as possible

causes.

The only real cure for preeclampsia and eclampsia is the birth of the baby. Mild

preeclampsia (blood pressure greater than 140/90) that occurs after 20 weeks of gestation

in a woman who did not have hypertension before; and/or having a small amount of

protein in the urine can be managed with careful hospital or in-home observation along

with activity restriction.

The group chose the case for the reason that they wanted to show the readers the

process on how pre-eclampsia occurs and for them to fully understand and be reminded

on one of the complications associated with pregnancy.

In developing countries: preeclampsia/eclampsia impact 4.4% of all deliveries (1)

and may be as high as 18% in some settings in Africa (2) If the rate of life threatening

eclamptic convulsions (0.1% of all deliveries) is applied to all deliveries from countries

considered to be the least developed, 50,000 cases of women experiencing this serious

complication can be expected each year. According to Safe Motherhood.org of the

585,000 maternal annually (3), 13%, or 76,050, are due to eclampsia.

Nurse-Centered Objectives

Upon completion of this case study, the student nurse should be able to:

1. Identify the risk factor contributing to the occurrence of the disease.

2. Formulate significant nursing diagnosis, with the significantly related nursing care

plan.

3. Identify the different medications administered for this disease their indications,

contraindications, side effect, and specific responsibility .

4. Identify the laboratory and diagnostic procedure done with the pre-eclamptic

patient, their indication and purposes, and specific nursing responsibilities.

Client-Centered Objectives

Upon completion of this case study, the client should be able to:

1. Understand awareness of her disease.

2. Know the possible causes of the disease.

3. Learn and understand why such laboratory examinations are being done.

II. NURSING HISTORY

a.) Demographic Data

Mrs. Ob, a 39 years old housewife and first time mother, who currently

resides at Guagua Pampanga with her husband Mr. Gyne. She was born a Filipina

on November 9, 1969 in Sta. Rita Guagua Pampanga. The patient was admitted at

a Regional Hospital with a chief complaint of abdominal pain, last November 15,

2008 at around 3:00 p.m.

b.) Socio-Economic and Cultural Factors

Mrs. Ob is plain housewife and her husband is an extra laborer on a

construction site. She graduated at a Public High School. And she didn’t continue

her college level due to financial problem.

Mrs. Ob was raised as a Roman Catholic, were she learned about religious

values but she still believes in super natural forces and superstitious beliefs. When

it comes in health matters, she seeks the help of a albularyo and uses herbal

medicines to treat any member of the family who has an ailment. But when

serious matters arise she still refers to medical professionals for help.

c.) Environmental factors

Ms. Ob resides at Guagua Pampanga and occupies the ancestry house of

her family. The location of their house is not easily accessible to hospitals, health

centers and other government institutions. Mrs. Ob did not report any problems

regarding her environment which interfered to her pregnancy.

Maternal-child Health History

a.) Maternal – Obstetric record (for OB cases)

Mrs. Ob was married to Mrs. Gyne at the age of 33 years old. She has a

record of T1P0A0L1M0 at her 39th week of gestation. She underwent low

transverse ceasarian section under a certain obstetrician at the regional hospital

last November 18, 2008 at around 10:00 in the evening, she delivered her 1st child

who is term baby with hyperbilirubinemia.

b.) Antepartal/ Prenatal Preparation

When Mrs. Ob was still pregnant, she only consulted once in a district

hospital all throughout.

c.) Significant Trimestral Changes (1st to 3rd trimester)

Mrs. Ob rxperienced some changes in her pregnancy, such as striae

gravidarum, linea nigra, and melasma. She also experienced nausea and vomiting,

dizziness, and headache.

Family Health Illness History

Legend:

hypertension

died of old age

pneumonia asthma deceased pre eclampsia

*pink border – mother side*blue border – father side*violet border - patient

Grandmother

Grandfather

Mother

Grandmother

Grandfather

Father

Patient

Both the grandparents from the mother’s side died from old age. From the father’s

side, the grandmother died from Hypertension and the father was died from Pneumonia.

The mother is not experiencing any health problems but the father has hypertension and

asthma. The patient, upon admission has elevated blood pressure and is suffering from

aggravating factors like anxiety, nervousness and fear.

PHYSICAL ASSESSMENT

November 27, 2008

SKIN

brown skin generally uniform in color except in areas exposed to the sun

skin temperature uniform and within the normal range (37°C)

when pinched, skin readily springs back to previous state

moist skin folds

nails with smooth texture

nail beds pink

prompt capillary refill time (2 seconds)

bipedal non-pitting edema

HEAD

absence of nodules or masses

symmetric facial features and movements

symmetric nasolabial folds

evenly distributed black hair

no infestations

EYES

eyebrows symmetrically aligned with equal movement

eyelashes equally distributed and curled slightly outward

skin of eyelids intact with no discoloration

lids close symmetrically

bilateral blinking exhibited

no discharge, edema or tearing

white sclera

pink palpebral conjunctiva

iris black in color

pupils equal in size with smooth borders

illuminated pupils constricts

pupils converge when near object is moved toward the nose

when looking straight ahead, the client can see objects in the periphery

both eyes coordinated, move in unison with parallel alignment

EARS

color same as facial skin

symmetrically aligned

pinna immediately recoils after it is folded

pinna is not tender

no lesions or discoloration

dry cerumen, grayish-tan color

normal voice tones audible

able to hear ticking of a watch in both ears

NOSE

symmetric and straight

no discharge or flaring

absence of lesions and tenderness

nasal septum intact and in the midline

MOUTH AND THROAT

outer lips uniform pink color with symmetric contour, soft and moist

buccal mucosa is of uniform pink color

gums are pink

tongue pink, moist, at central position

NECK

head centered

lymph nodes not palpable

BREAST

firm

generally symmetric in size

CARDIOVASCULAR

BP 180/100 mmHg

PR 114

reported palpitations

symmetric pulse strength

RESPIRATORY/CHEST

chest symmetric

chest wall intact, no tenderness, no masses

symmetric chest expansion and excursion

RR: 29 breaths per minute

GASTROINTESTINAL/ABDOMEN

striae present at hypogastric and iliac regions

linea nigra present

no tenderness

presence of surgical incision

URINARY

absence of nocturia, dysuria, urgency, hesitancy,

light yellow urine

REPRODUCTIVE

regular menstrual cycle

G1P1

MUSCULOSKELETAL/EXTREMITIES

muscle equal size on both sides of the body

no bone deformities

no tenderness

NEUROLOGIC

can respond to verbal commands

oriented

conscious

displayed anxiety

PHYSICAL ASSESSMENT

November 28, 2008

SKIN


skin temperature uniform and within the normal range (37°C)

good skin turgor

moist skin folds


nail beds pink

prompt capillary refill time


HEAD

rounded

smooth skull contour

symmetric facial features


symmetric facial movements

HAIR

thick black hair

evenly distributed

no infestations

EYES

eyebrows symmetrically aligned

eyelashes curled slightly outward

exhibited bilateral blinking

both eyes coordinated, move in unison and with parallel alignment

white sclera


pupils equally round and reactive to light and accommodation

iris black in color

pupils equal in size with smooth borders

illuminated pupils constricts

no discharge

EARS

color same as facial skin


pinna immediately recoils after it is folded

pinna is not tender




NOSE AND SINUSES


no discharge



sinuses not tender

MOUTH AND THROAT

outer lips uniform pink color

symmetric contour


no abrasions and ulcerations

gums are pink


tongue moves freely with no tenderness

palate surface intact

uvula positioned in midline

palatine tonsils pink and smooth and not swollen

NECK

head centered

head movement coordinated and smooth with no discomfort


BREAST AND AXILLAE

rounded, generally symmetric

areola rounded and the same shape

nipples round, everted and equal in size

milk letdown

CARDIOVASCULAR

BP 160/100 mmHg

PR 106

prompt capillary refill time (less than 1 second)

symmetric pulse strength

RESPIRATORY/CHEST

chest symmetric


full symmetric chest expansion and excursion

respiratory rate of 22 breaths per minute



symmetric movement caused by respiration

tender because of suture from cesarean operation

URINARY

yellowish urine

REPRODUCTIVE


G1P1 (1-0-0-1-0)



equal strength

no bone deformities

no tenderness

no tenderness on calf muscle when dorsiflexed

NEUROLOGIC


oriented

conscious

PHYSICAL ASSESSMENT

November 29, 2008

SKIN


skin temperature uniform and within the normal range (37.2°C)

when pinched, skin readily springs back to previous state

moist skin folds


nail beds pink

nail plate angle about 160°

prompt capillary refill time


HEAD

rounded

smooth skull contour

no masses, tenderness in the scalp

symmetric facial features


symmetric facial movements

HAIR

thick, evenly districbuted black hair

no infestations

EYES

eyebrows symmetrically aligned

exhibited bilateral blinking

anicteric sclera


pupils equally round and reactive to light and accommodation

no discharge

EARS


pinna not tender and immediately recoils after folded




able to hear ticking of a watch in both ears

NOSE AND SINUSES


no discharge or flaring



both nares patent

MOUTH AND THROAT

outer lips uniform pink color

symmetric contour


gums are pink


palate surface intact

uvula positioned in midline

palatine tonsils pink and smooth and not swollen

gag reflex present

30 adult teeth, 2 molars missing, 1 with black discoloration of the enamel

NECK

neck muscles equal in size, head centered

head movement coordinated and smooth with no discomfort


BREAST AND AXILLAE

areola rounded and the same shape

nipples round, everted and equal in size

milk letdown

CARDIOVASCULAR

BP 150/100 mmHg

PR 96

strong, regular rhythm

prompt capillary refill time (less than 1 second)

RESPIRATORY/CHEST

chest symmetric

right and left shoulders and right and left hips are at the same height


full symmetric chest expansion and excursion

respiratory rate is 28 breaths per minute



rounded contour

symmetric movement caused by respiration

tender because of suture form cesarean operation

URINARY

yellowish urine

REPRODUCTIVE


G1P1 (1-0-0-1-0)



smooth coordinated movements

equal strength

no tenderness

walks aided to maintains balance

no tenderness on calf muscle when dorsiflexed

NEUROLOGIC


oriented

conscious

DIAGNOSTIC AND LABORATORY PROCEDURES

Diagnostic or Laboratory Procedure

Indication or Purpose

Date Ordered and

Date Results were

released

ResultsNormal Values

Analysis and Interpretation

of Results

WBC Count To determine

infection or

inflammation

Pre-operation

assessment of

the patient.

November

16, 2008

8.0 5-10 x

109/L

No infection

or

inflammation

is present.

RBC Count Pre-operation

assessment of

the patient.

November

16, 2008

3.3 4.2-5.4 x

1012 /L

Decreased

RBC count on

pregnant is

normal

because of the

increase in

plasma volume

during

pregnancy.

Hemoglobin Pre-operation

assessment of

the patient.

November

16, 2008

96 120-

160g/L

The result

indicates that a

1000 ml

sample of

blood contains

96 g of

hemoglobin.

Decreased

hemoglobin on

pregnant is

normal

because of

their increase

in plasma

volume.

Hematocrit

(%)

Pre-operation

assessment of

the patient.

November

16, 2008

0.29 0.37-0.47

g/L

The result

indicates that a

1000 ml

sample of

blood contains

.29 g of

hemoglobin.

Decreased

hematocrit on

pregnant is

normal

because of

their increase

in plasma

volume.

Nursing Responsibilities During Different Laboratory Procedures

White Blood Cell Count

Before

Explain to the patient that the WBC test is used to detect an infection or

inflammation.

Tell the patient that the test requires a blood sample. Explain who will perform

the venipuncture and when.

Explain to the patient that he may experience slight discomfort from the needle

puncture and the tourniquet.

Inform the patient that he should avoid strenuous exercise for 24 hours before the

test. Also tell him that he should avoid eating a heavy meal before the test.

If the patient is being treated for an infection, advise him that this test will be

repeated to monitor his progress.

Notify the laboratory and physician of medications the patient is taking that may

affect test results: they may need to be restricted.

During

Ensure subdermal bleeding has stopped before removing pressure.

After

If a hematoma develops at the venipuncture site, apply warm soaks. If the

hematoma is large, monitor pulses distal the venipuncture site.

Inform the patient that he may resume his usual diet, activity and medications

discontinued before the test, as ordered.

A patient with severe leucopenia, they have little or no resistance to infection and

requires protective isolation.

Red Blood Cell Count

Before

Explain to the patient that RBC count is used to evaluate the number of RBCs and

to detect possible blood disorders.





Inform the patients that he need not restrict foods and fluids

During


After

If a hematoma develops at the venipuncture site, apply warm soaks.

Hemoglobin

Before

Explain to the patient that the hbg test is used to detect anemia or polycythemia or

to assess his response to treatment.





During


After


Hematocrit

Before

Explain to the patient that hct is tested to detect anemia and other abnormal

conditions





Inform the patients that he need not restrict foods and fluids

During


After


III. THE PATIENT AND HIS ILLNESS

Efforts to unravel the pathogenesis of pre-eclampsia have been hampered by the

lack of clear diagnostic criteria for the disease and its subtypes. Consequently, several

studies have included a variety of other conditions that do not necessarily reflect an

adverse pregnancy outcome.

Abnormal placentation (stage 1), particularly lack of dilatation of the uterine

spiral arterioles, is the common starting point in the genesis of pre-eclampsia, which

compromises blood flow to the maternal–fetal interface. Reduced placental perfusion

activates placental factors and induces systemic hemodynamic changes. The maternal

syndrome (stage 2) is a function of the circulatory disturbance caused by systemic

maternal endothelial cell dysfunction resulting in vascular reactivity, activation of

coagulation cascade and loss of vascular integrity. Pre-eclampsia has effects on most

maternal organ systems, but predominantly on the vasculature of the kidneys, liver and

brain.

V. THE PATIENT AND HIS CARE

1. Medical Management

a. IVFs, BT, NGT feeding, Nebulization, TPN, Oxygen Therapy

Medical

Management

Date Ordered General

Description

Indication &

Purpose

Client

Response to

Treatment

IVF

D5LRS 1L

30gtts/min

Date Ordered

November 15,

2008

Date d/c

November 20,

2008

5% dextrose in

lactated ringers

solution

(Osmolarity of

527-hyprtonic,

pH of 4.9) -

provides

calories and free

water, provides

electrolytes.

Also contains

sodium lactate

which is used in

treating mild to

moderate

metabolic

acidosis.

D5NM is

administered by

intravenous

infusion for

parenteral

maintenance of

routine daily

fluid and

electrolyte

requirement with

minimal

carbohydrates

calories and to

correct or replace

fluid losses due

to change in the

patient’s diet

(NPO) and

during the

cesarean

The patient

responded well

with no signs of

irritation and

adverse

reactions.

operation.

Nursing Responsibilities:

Check the doctor’s order

Explain the procedure to the patient

Tell the patient that she might feel a discomfort from the tourniquet and the IV

insertion

Check and monitor IVF regulation and level of fluid

Check if there is a need for removal and replacement of fluid

Check if the tube is in the vein and signs of edema

Check if there is a back-flow of blood

Check if there is bubbles present in the tube

Always Monitor V/S.

b. Pharmacotherapy

Brand name and

Generic name

Date ordered/

Date started/

Date changed/

Route of

Administration,

Dosage and

Frequency of

Administration

General action Client response

Mefenamic

Acid

11-19-08 P.O., 500mg,

TID for pain

Inhibits

prostaglandin

synthesis by

decreasing the

activity of the

enzyme,

cyclooxygenase,

which results in

Patient was

relieved from

pain.

decreased

formation of

prostaglandin

precursors

Cephalosporin

Cefuroxime

sodium

11-19-08 I.V., 750mg, q8 Inhibits bacterial

cell wall

synthesis by

binding to one or

more of the

penicillin-

binding proteins

(PBPs) which in

turn inhibits the

final

transpeptidation

step of

peptidoglycan

synthesis in

bacterial cell

walls, thus

inhibiting cell

wall

biosynthesis.

Bacteria

eventually lyse

due to ongoing

activity of cell

wall autolytic

enzymes

The patient did

not acquire

infection and

did not

experience any

adverse

reaction.

(autolysins and

murein

hydrolases)

while cell wall

assembly is

arrested.

Ferrous Sulfate 11-19-08 P.O., O.D. Replaces iron,

found in

hemoglobin,

myoglobin, and

other enzymes;

allows the

transportation of

oxygen via

hemoglobin.

The patient

responded well

to treatment

and did not

experience any

adverse

reaction.

Nifedipine 11-19-08 P.O., 10mg, BID Inhibits calcium

ion from

entering the

"slow channels"

or select

voltage-sensitive

areas of vascular

smooth muscle

and myocardium

during

depolarization,

producing a

relaxation of

The patient

responded well

to treatment

and did not

experience any

adverse

reaction.

coronary

vascular smooth

muscle and

coronary

vasodilation;

increases

myocardial

oxygen delivery

in patients with

vasospastic

angina

c. Diet

Type of Diet Date Ordered,

Date Performed,

Date Administer

General

Description

Indication &

Purpose

Client

Response to

Treatment

NPO 11-17-08

11-19-08

The patient is not

allowed to take

any oral food or

liquid

This is done to

prevent

alteration of the

result of the

fasting blood

sugar.bcs intake

of food can

increase

glucose level

The patient

complied with

the prescribed

diet.

Clear Liquid

Diet

11-19-08 A diet of clear

liquids maintains

This diet reduce

stimulation of

The patient

complied with

11-20-08 vital body fluids,

salts, and

minerals; and also

gives some energy

for patients when

normal food intake

must be

interrupted. Clear

liquids are easily

absorbed by the

body. by mouth

(NPO) for a long

time. This diet is

also used in

preparation for

medical tests such

as sigmoidoscopy,

colonoscopy, or

certain x-rays.

the digestive

system, and

leave no residue

in the intestinal

tract. This is

why a clear

liquid diet is

often prescribed

in preparation

for surgery, and

is generally the

first diet given

by mouth after

surgery. Clear

liquids are

given when a

person has been

without food by

mouth (NPO)

for a long time.

the prescribed

diet.

d. Exercise

Activity General Purpose Date Order Client

Description Response

Complete Bed

Rest

Prescribed

maternal

complication of

pregnancy

To provide

adequate rest

11-18-08 The client

adhered to the

order without

complaints.

VI. NURSING CARE PLAN

Cues Nursing diagnoses

Scientific Explanation

Objective Nursing intervention

Rationale Expected outcomes

S-“sumasakit

nga daw ung

tahi niya at

sumusigaw siya”

as the SO

verbalized

O- facial

grimaces

Rated pain as 8

in a pain scale of

1-10, 10 being

the highest

Acute pain

related to

postparum

Unpleasant

sensory

experience

arising from post

surgical incision

from cesarean

section.

After 2-4 hr of

nursing

intervention, the

pt rate the pain

from 8 to 3 in a

pain scale of 1-

10

- Provide quite

environment

-Encouraged to

do deep

breathing

exercise

- Encouraged

adequate rest

period

-to promote pain

management.

-to reduce tension

-to prevent

fatigue

-to reduce

pressure on the

Goal Partially

met AEB pt

rated the pain

from 8 to 5 in a

pain scale of 1-

10

Guarding

behavior

- Encouraged to

support the

affected area

upon movement

affected area





S-“ayoko na

muna dapat

mabuntis kc

papangit ung

katawan ko

tsaka bat ang

itim ng pek-pek

ko” as pt

verbalized

Disturbed body

image related to

pregnancy AEB

changes in

appearance

Severity of the

abdominal

wound due to

surgery, a new

type of tissues

develops that

eventually will

causes scar

formation

After 2-4 hrs of

nursing

intervention, the

patient will able

to understand the

change of body

image.

-Encouraged

client to looked/

touch the

affected body

area

-Encourage the

client to have a

daily exercise.

-to begin to

incorporate

changes into

body image.

-to bring back

the usual

physical images.

Goal met the

patient

recognized and

verbalized

understanding of

body changes.

O-presence of

melasma

-presence of

bipedal edema

-Advised the SO

to give support

to the pt

(especially

emotional

feelings)

-Assist pt to

identify positive

behavior

-to feel that the

patient still

worthy.

-to aid in

recovery.





S: “bumibilis

nga tibok ng

puso ko”

verbalized by

the patient

O: -with the

tenderness of

abdominal are

-facial grimaces

-BP= 160/100

mmhg

Decreased

cardiac output

related to altered

heart rate (111

bpm) AEB

tachycardia, pt’s

report of

palpations;

(r/t) decreased

venous return

AEB edema

(ankle), SOB

(28)

Pregnancy

Induced

Hypertension is a

condition in

which

vasospasms

occur. It is caused

by altered cardiac

output that injures

endothelial cells

of the arteries.

Blood vessels

become less

resistant to

After 4 hrs of

nursing

intervention, the

patient will

display

hemodynamic

stability (heart

rate will decrease

from 111 bpm to

100 bpm, BP

from 140/100 to

120/80)

-Keep client on

bed and in

position of

comfort

-decrease

stimuli; provide

quiet env’t

-Encouraged

deep breathing

exercise

-Encouraged

- decreases

oxygen

consumption

-to promote

adequate rest

-to reduce

anxiety

-to reduce risk for

orthostatic

Goal Met AEB

within 4 hrs. of

nursing

intervention the

pt. HR

decreased from

111 bpm to 100

bpm, BP from

140/100 to

120/80 (Normal

BP)

RR= 28 cycles

per min.

PR= 111 bpm

pressor

substances. This

results to

vasoconstriction

and increases BP

dramatically

changing

positions slowly

-give

information

about positive

signs of

improvement

-Instruct client to

avoid or limit

activities that

may stimulate

valsalva

response (rectal

stimulation,

hypotension

-to provide

encouragement

-to prevent in

changes in

cardiac pressures

or impede blow

flow

bearing down

B.M)





S- Risk for Constipation After 4 hrs of - Educate - Information Goal Met AEB

O- decreased

ambulation of

the patient bcs

of pain and the

complete bed

rest ordered of

the physician.

constipation

related to post

CS delivery.

may happen due

to disturbance of

normal bowel

movements

because

intestines were

displaced during

surgical

procedure.

nursing

intervention, the

patient will

verbalize

understanding

the etiology and

appropriate

intervention if

constipation may

occur.

patient/ SO

about safe and

risky practices

for managing

constipation.

- Instruct balance

fiber and bulk in

diet and fiber

supplements.

- Promote

adequate fluid

intake, also

suggest drinking

warm fluids.

can help client to

make beneficial

choices when

need arises.

- To improve

consistency of

stool and

facilitate passage

through colon.

- To promote

soft stool and

stimulate bowel

the patient

verbalized

understanding

about

constipation and

gained

knowledge of

appropriate

intervention.

- Encourage

activity within

limits of

individual

ability.

activity.

-To stimulate

constrictions of

the intestines





O- postpartum

surgery

Impaired Skin

Integrity related

The incision

from the

After 2-4 hrs of

nursing

-stress proper - to control the

spread of

Goal Met AEB

the patient was

to surgery cesarean section

altered the skin

integrity making

it more

susceptible to

pathogens and

even the pt’s

normal flora

intervention, the

patient will able

to know the

preventive

measures of

wound healing

hand hygiene.

-Encouraged to

increase foods

that are rich in

protein

-Encouraged

proper clothing

-Apply

appropriate

dressing

infection.

- to aid in tissue

repair

-to maintained the

proper skin

moisture.

-to help in wound

healing

able to knew

the preventive

measures of

wound healing

VIII. Discharge Plan

General Condition of client upon discharge

During nurse-patient interaction upon discharge, the patient was wearing a

comfortable pair of white shirt and white pajama and a pair of flat slip-ons while being

sealed on a chair cuddling her baby boy. Her hair was untidy and up in a ponytail with

visible infestations. She was oriented enough to follow instructions and answers

questions asked by the student nurse.

Methods

M- Instructed the patient to take the following home medication as ordered by the

physician:

Mefenamic Acid 500mg PRN

Ferrous Sulfate OD

Nifedipine 10mg BID

E- Instructed patient to avoid strenuous activities. And practice deep breathing

exercise.

T- n/a

H- Instructed patient to take a bath everyday. Emphasize the importance of breast

feeding.

O- Advice to visit or have a follow up check-up with her attending physician.

D- Low fat, Low salt diet.

IX. Conclusion

Nurses can help the nation achieve National Health Goals. These goals speak

directly to both fetus and the mother because pregnancy is a high risk factor for them.

Close monitoring in pregnant women and health teaching as much as possible about

pregnancy could definitely reduce life threatening complications.

Studies shows that there is no certain facts that will give us the idea where pre-

eclampsia arise. But there so many factors that could prevent this complication such as

diet modifications, proper compliance with the health care providers, proper exercise.

And if the complication is already present, proper monitoring, proper diet and drug

compliance should be ruled in.

X. Recommendations

With this study, the student nurses were able to gain more knowledge and wider

view and perspective of the complication of pregnancy which is pre-eclampsia. Thus, the

student nurses would like recommend and share some pointers on how to deal with

different diseases with pregnancy specifically pre-eclampsia.

To the government, primarily they should allocate sufficient budget to sustain and

provide better facilities. They must be responsible enough to create awareness program

for care and management for all the Filipino people.

To the health care team, they should righteously implementing basic and ideal

procedures regardless of the health care facilities where they belong. They must observe

and always remember to keep in line with their duties towards both the mother and the

child during the pregnancy.

To the community and the family, that they must be insufficient coordination with

the government and the health care team regarding promotion of health before, during,

and after the delivery of the baby.

XI. BIBLIOGRAPHY

http:// www.nursingcrib.com

http:// www.medicinenet.com

http:// www.wrongdiagnosis.com

http:// www.umm.edu.com

http:// www.doh.gov.ph

http://www.doh.gov.ph/

http://www.umm.edu.com/

http://www.wrongdiagnosis.com/

http://www.medicinenet.com/

http://www.nursingcrib.com/

case study pre-eclampsia

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