Outcomes and prognosis
Outcomes and prognosis ( 5 Questions)
A nurse is assessing a client with gestational hypertension who is at 34 weeks of gestation.
The nurse notes that the client’s blood pressure is 160/100 mmHg, her urine protein is 3+, and she has mild edema in her lower extremities.
The nurse also observes that the client has brisk deep tendon reflexes and clonus.
How should the nurse interpret these findings?
The client has more than mild preeclampsia. Mild preeclampsia is diagnosed when the blood pressure is at least 140/90 mmHg, the urine protein is 1+ or 2+, and there are no signs of organ damage or central nervous system involvement. Close monitoring may be appropriate for mild preeclampsia, depending on the gestational age and fetal status.
Severe preeclampsia is diagnosed when the blood pressure is at least 160/100 mmHg, the urine protein is 3+ or more, and there are signs of organ damage or central nervous system involvement, such as brisk deep tendon reflexes and clonus. These findings indicate a high risk of eclampsia, which is a life-threatening condition characterized by seizures. Immediate delivery is the only definitive treatment for preeclampsia and eclampsia.
The client does not have eclampsia yet. Eclampsia is diagnosed when the client has preeclampsia and seizures. Magnesium sulfate and anticonvulsants are used to prevent and treat seizures in eclampsia, but they do not cure preeclampsia. Delivery is still necessary to resolve the condition.
The client does not have chronic hypertension. Chronic hypertension is high blood pressure that was present before pregnancy or that occurs before 20 weeks of gestation. The client’s blood pressure was normal before pregnancy and increased after 20 weeks of gestation, indicating gestational hypertension or preeclampsia.
Antihypertensive medication adjustment may be needed for chronic hypertension
The correct answer is choice B. The client has severe preeclampsia and needs immediate delivery. Severe preeclampsia is diagnosed when the blood pressure is at least 160/100 mmHg, the urine protein is 3+ or more, and there are signs of organ damage or central nervous system involvement, such as brisk deep tendon reflexes and clonus. These findings indicate a high risk of eclampsia, which is a life-threatening condition characterized by seizures. Immediate delivery is the only definitive treatment for preeclampsia and eclampsia.
Choice A is wrong because the client has more than mild preeclampsia. Mild preeclampsia is diagnosed when the blood pressure is at least 140/90 mmHg, the urine protein is 1+ or 2+, and there are no signs of organ damage or central nervous system involvement. Close monitoring may be appropriate for mild preeclampsia, depending on the gestational age and fetal status.
Choice C is wrong because the client does not have eclampsia yet. Eclampsia is diagnosed when the client has preeclampsia and seizures. Magnesium sulfate and anticonvulsants are used to prevent and treat seizures in eclampsia, but they do not cure preeclampsia. Delivery is still necessary to resolve the condition.
Choice D is wrong because the client does not have chronic hypertension. Chronic hypertension is high blood pressure that was present before pregnancy or that occurs before 20 weeks of gestation. The client’s blood pressure was normal before pregnancy and increased after 20 weeks of gestation, indicating gestational hypertension or preeclampsia.
Antihypertensive medication adjustment may be needed for chronic hypertension