Preeclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks' gestation and can present as late as 4-6 weeks postpartum. It is clinically defined by hypertension and proteinuria, with or without pathologic edema.
Preeclampsia is part of a spectrum of hypertensive disorders that complicate pregnancy. These include chronic hypertension, preeclampsia superimposed on chronic hypertension, gestational hypertension, preeclampsia, and eclampsia. Although each of these disorders can appear in isolation, they are thought of as progressive manifestations of a single process and are believed to share a common etiology.
The exact cause of preeclampsia is not known. Possible causes include:
- Autoimmune disorders
- Blood vessel problems
- First pregnancy
- Multiple pregnancy (twins or more)
- Older than age 35
- Past history of diabetes, high blood pressure, or kidney disease.
Often, women who are diagnosed with preeclampsia do not feel sick.
Symptoms of preeclampsia can include:
- Swelling of the hands and face/eyes (edema)
- Weight gain
- More than 2 pounds per week
- Sudden weight gain over 1 - 2 days
Symptoms of more severe preeclampsia:
- Headaches that are dull or throbbing and will not go away
- Abdominal pain, mostly felt on the right side, underneath the ribs. Pain may also be felt in the right shoulder, and can be confused with heartburn, gallbladder pain, a stomach virus, or the baby kicking
- Decreased urine output, not urinating very often
- Nausea and vomiting (worrisome sign)
- Vision changes -- temporary loss of vision, sensations of flashing lights, auras, light sensitivity, spots, and blurry vision.
Nursing Care Plan for Preeclampsia
- Subjective Data :
- Age is usually common in primigravida, less than 20 years or more than 35 years.
- Health history is now: increased blood pressure, edema, headache, epigastric pain, nausea, vomiting, blurred vision.
- Previous health history: kidney disease, anemia, vascular essential, chronic hypertension, diabetes mellitus.
- History of pregnancy: a history of multiple pregnancy, hydatidiform mole, hidramnion and the history of pregnancy with preeclampsia or eclampsia before.
- Pattern of nutrition: the type of food consumed staple food good or distraction.
- Psychosocial: Unstable Emotions can lead to anxiety, and therefore need moral readiness to face the risks.
- Objective Data :
- Inspection: edema did not disappear within 24 hours.
- Palpate: to know the uterine fundus height, location of the fetus, the location of edema.
- Auscultation: listening to fetal heart rate to determine the existence of fetal distress.
- Percussion: to know the patellar reflex.
- Other Assessments :
- Vital Signs: Measuring in a reclined position or sleeping, measured 2 times with an interval of 6 hours.
- Laboratory: urine protein, with a catheter or midstream (usually increased to 0.3 g / lt or +1 to +2 on the qualitative scale), decreased hematocrit levels, increased serum creatinine, uric acid is usually> 7 mg/100 ml.
- Weight: weight increase over 1 kg / week.
- Level of consciousness: a reduction in GCS as a sign of abnormalities in the brain.
- Ultrasound: to know the state of the fetus.