Ch 27; Lesson - Nursing care
management of Preeclampsia and
Eclampsia well answered to pass
Which plan for birth is most appropriate for a pregnancy complicated by hypertension without
severe features?
a. Intended vaginal birth with induction of labor at 37 weeks
b. Induction of labor at 38 weeks, intended vaginal birth
c. Planned cesarean section at 37 weeks
d. Expectant management until 40 weeks gestation, then induction of labor - ANS ✔✔a.
Intended vaginal birth with induction of labor at 37 weeks
At 37 weeks, the newborn is considered "term" and is not expected to need supportive
measures. Because of this, the newborn is safer outside of the womb at 37 weeks, than inside
the womb in the presence of preeclampsia. A vaginal birth is much safer for the mother than a
cesarean and should be attempted.
Which symptom may be observed in a pregnancy complicated by preeclampsia with severe
features?
Select all that apply. One, some, or all responses may be correct.
Headache
Right upper quadrant pain
Slurred speech
Bradycardia
, Decreased urine output
Blurry or double vision - ANS ✔✔Headache
Right upper quadrant pain
Decreased urine output
Blurry or double vision
Headaches that are not relieved by analgesics are a common symptom of preeclampsia due to
cerebral edema and central nervous system irritability. Pain can occur in the right upper
quadrant because the liver is affected by preeclampsia, as hepatic edema may develop, and is
located in the right upper quadrant of the abdomen. Preeclampsia impacts the kidneys and
kidney perfusion, leading to a decrease in urine output. Blurry or double vision or seeing spots
may occur with preeclampsia due to a decreased blood flow to the retinas and central nervous
system irritability.
Which nursing intervention is appropriate during induction of labor for a woman with
preeclampsia?
a. Provide intermittent monitoring in early labor, followed by continuous fetal monitoring until
the birth.
b. Encourage oral hydration and provide IV bolus of 125 ml every hour to maintain hydration.
c. Ensure the client remains in bed with rails up on both sides.
d. Educate the patient that her uterus feeling tender is normal for medical inductions. - ANS
✔✔Ensure the client remains in bed with rails up on both sides.
Ensuring the client remains in bed with rails up on both sides is part of seizure precautions and
will help prevent falls in the event of a seizure. Continuous fetal monitoring and monitoring of
contractions are indicated throughout the induction. Fluids (both oral and IV) should be
monitored and should not exceed 125 ml/hour to prevent pulmonary edema. A tender uterus is
a sign of placental abruption which requires immediate action.
management of Preeclampsia and
Eclampsia well answered to pass
Which plan for birth is most appropriate for a pregnancy complicated by hypertension without
severe features?
a. Intended vaginal birth with induction of labor at 37 weeks
b. Induction of labor at 38 weeks, intended vaginal birth
c. Planned cesarean section at 37 weeks
d. Expectant management until 40 weeks gestation, then induction of labor - ANS ✔✔a.
Intended vaginal birth with induction of labor at 37 weeks
At 37 weeks, the newborn is considered "term" and is not expected to need supportive
measures. Because of this, the newborn is safer outside of the womb at 37 weeks, than inside
the womb in the presence of preeclampsia. A vaginal birth is much safer for the mother than a
cesarean and should be attempted.
Which symptom may be observed in a pregnancy complicated by preeclampsia with severe
features?
Select all that apply. One, some, or all responses may be correct.
Headache
Right upper quadrant pain
Slurred speech
Bradycardia
, Decreased urine output
Blurry or double vision - ANS ✔✔Headache
Right upper quadrant pain
Decreased urine output
Blurry or double vision
Headaches that are not relieved by analgesics are a common symptom of preeclampsia due to
cerebral edema and central nervous system irritability. Pain can occur in the right upper
quadrant because the liver is affected by preeclampsia, as hepatic edema may develop, and is
located in the right upper quadrant of the abdomen. Preeclampsia impacts the kidneys and
kidney perfusion, leading to a decrease in urine output. Blurry or double vision or seeing spots
may occur with preeclampsia due to a decreased blood flow to the retinas and central nervous
system irritability.
Which nursing intervention is appropriate during induction of labor for a woman with
preeclampsia?
a. Provide intermittent monitoring in early labor, followed by continuous fetal monitoring until
the birth.
b. Encourage oral hydration and provide IV bolus of 125 ml every hour to maintain hydration.
c. Ensure the client remains in bed with rails up on both sides.
d. Educate the patient that her uterus feeling tender is normal for medical inductions. - ANS
✔✔Ensure the client remains in bed with rails up on both sides.
Ensuring the client remains in bed with rails up on both sides is part of seizure precautions and
will help prevent falls in the event of a seizure. Continuous fetal monitoring and monitoring of
contractions are indicated throughout the induction. Fluids (both oral and IV) should be
monitored and should not exceed 125 ml/hour to prevent pulmonary edema. A tender uterus is
a sign of placental abruption which requires immediate action.
