Case Study Hypertensive Crisis (Eclampsia) A 36 year old pregnant patient is in the labor and delivery unit of the hospital. She is 37 weeks’ gestation with her second pregnancy and has had spontaneous rupture of membranes. The patient has been followed closely by her obstetric nurses/gynecology nurses because of her history of high blood pressure during both her last pregnancy and with the current pregnancy. The patient arrived in the labor and delivery unit 6 hours ago and has been having regular contractions and increasing pain and has cervical dilation of 6cm. upon admission to the unit, the patient’s vital signs were: HR 98 bpm, RR 16/minute, BP 128/78 mmHg, T 98.1°F. The client has been taking nicardipine to control her blood pressure during this pregnancy. The patient calls the nurse into her room because she has developed a sudden and severe headache; most of the pain is located behind her right eye. She tells the nurse that she feels dizzy and asks her to turn off the overhead light because she says it hurts her eyes. The nurse performs a rapid assessment and notes that the patient’s HR is 116 and her pulse is full and bounding; her BP is 168/120 mmHg and she is breathing rapidly.
1. The nurse suspects that the patient is experiencing a hypertensive crisis as a result of pre- eclampsia and based on her symptoms and her blood pressure. What other signs or symptoms would be present for this patient to be diagnosed as having a hypertensive emergency?
2. What potential body system complications could develop as a result of unresolved hypertensive crisis? The nurse performs a rapid urinalysis test from a sample of the patient’s urine, which demonstrates elevated levels of urinary protein. After contacting the physician, the nurse received orders to check a complete metabolic panel and to get and EDG stat. the nurse checks the fetal monitor to ensure that the baby is not in distress because of the mother’s condition.
3. After completing the physician’s orders, describe in order the interventions the nurse would perform to control this patient’s condition.
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