Maternity Nursing: Antepartum Q 7
A homecare nurse visits a pregnant client who has a diagnosis of mild Preeclampsia and who is being monitored for pregnancy induced hypertension (PIH). Which assessment finding indicates a worsening of the preeclampsia and the need to notify the physician?
A. Blood pressure reading is at the prenatal baseline.
B. Urinary output has increased.
C. The client complains of a headache and blurred vision.
D. Dependent edema has resolved.
Correct Answer: C. The client complains of a headache and blurred vision.
If the client complains of a headache and blurred vision, the physician should be notified because these are signs of worsening preeclampsia.
Option A: In normal pregnancy, women’s mean arterial pressure drops 10-15 mm Hg over the first half of pregnancy. Most women with mild chronic hypertension (ie, SBP 140-160 mm Hg, DBP 90-100 mm Hg) have a similar decrease in blood pressures and may not require any medication during this period.
Option B: In addition to rising hormones, the body’s fluid levels start to increase during pregnancy. This means the kidneys have to work extra hard to flush the extra fluid. The amount of urine released will increase as well. In the third trimester, the baby’s growing size means they’re pressing even more on the bladder.
Option D: During normal pregnancy total body water increases by 6 to 8 liters, 4 to 6 liters of which are extracellular, of which at least 2 to 3 liters are interstitial. At some stage in pregnancy 8 out of 10 women have demonstrable clinical edema.