Question

Preeclampsia Case Study

Cindy, a 17-year-old G1P0, has presented to the physician’s office for her 34-week prenatal visit. The following assessment data is obtained: Prenatal weight: 115 Weight at 30 weeks: 145 Current weight: 160 Vital Signs: BP- 146/92 (baseline BP- 120/66) P- 84 R-20 Fundal height: 32cm Urine dipstick: Protein: 2+ Glucose: negative Complaints of pain in upper right abdominal quadrant, unable to wear shoes due to swelling in feet, hands, and fingers swollen, having frequent headaches.

1. Identify the abnormal assessment data and discuss indications of each.

2. Identify the risk factors that place Cindy at a higher risk of developing preeclampsia.

3. What lab work and/or diagnostic tests would be ordered to provide additional information on the status of Cindy’s physiological status and the status of the fetus?

4. Discuss the interventions for the treatment of preeclampsia and the assessment of fetal status.

5. What additional assessment data will be gathered on Cindy during her future prenatal visits? What would this assessment data indicate about her physiological status?

6. What conditions is Cindy at risk for if her preeclampsia continues to worsen?

Answer 1

1. Identify the abnormal assessment data and discuss indications of each.
   Sudden weight gain 15lbs, increased blood pressure, presence of protein in urine, abdominal pain, swelling, frequent headache are abnormal findings, and they are the symptoms of preeclampsia.
   
2. Identify the risk factors that place Cindy at a higher risk of developing preeclampsia.
   Based on available data; in this case, age (less than 20 years) and first pregnancy are the risk factors.
3. What lab work and/or diagnostic tests would be ordered to provide additional information on the status of Cindy’s physiological status and the status of the fetus?
   Fetal ultrasound, serum transaminase level, serum albumin level, coagulation test, lactate dehydrogenase level and platelet count.
4. Discuss the interventions for the treatment of preeclampsia and the assessment of fetal status.
   Medications to lower Blood pressure, corticosteroids to improve liver function and increase platelet count. Also, anticonvulsants to prevent seizures if occurs. Corticosteroids also fetal lung growth. Regular fetal ultrasound is required to assess fetal growth status.
5. What additional assessment data will be gathered on Cindy during her future prenatal visits? What would this assessment data indicate about her physiological status?
   Additional assessment should be carried out to find lung edema, onset of seizures and vision abnormality.
   Blood pressure, liver function, urine analysis and ultrasound should be continued.
6. What conditions is Cindy at risk for if her preeclampsia continues to worsen?
   If her preeclampsia continues to worsen, she experiences continuous weight gain, hypertension, convulsion, vision abnormality and impaired liver function. It leads to induced labor based on fetus condition.