Maternity Nursing Q 156

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Which of the following would the nurse identify as a classic sign of PIH?

  

     A. Edema of the feet and ankles

     B. Edema of the hands and face

     C. Weight gain of 1 lb/week

     D. Early morning headache

    

    

Correct Answer: B. Edema of the hands and face

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Edema of the hands and face is a classic sign of PIH. Aggressive volume resuscitation may lead to pulmonary edema, which is a common cause of maternal morbidity and mortality. Pulmonary edema occurs most frequently 48-72 hours postpartum, probably due to mobilization of extravascular fluid. Because volume expansion has no demonstrated benefit, patients should be fluid restricted when possible, at least until the period of postpartum diuresis.

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Option A: Many healthy pregnant women experience foot and ankle edema. During pregnancy, the extra fluid in the body and the pressure from the growing uterus can cause swelling (or “edema”) in the ankles and feet. The swelling tends to get worse as a woman’s due date nears, particularly near the end of the day and during hotter weather.

Option C: A weight gain of 2 lb or more per week indicates a problem. High pregnancy weight gain was more strongly associated with term preeclampsia than early preterm preeclampsia (eg, 64% versus 43% increased odds per 1 z score difference in weight gain in normal-weight women, and 30% versus 0% in obese women, respectively).

Option D: Early morning headache is not a classic sign of PIH. Dull or severe, throbbing headaches, often described as migraine-like that just won’t go away are cause for concern.

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