Maternity Nursing Q 377

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A client with severe preeclampsia is admitted with BP 160/110, proteinuria, and severe pitting edema. Which of the following would be most important to include in the client’s plan of care?

  

     A. Daily weights

     B. Seizure precautions

     C. Right lateral positioning

     D. Stress reduction

    

    

Correct Answer: B. Seizure precautions

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Women hospitalized with severe preeclampsia need decreased CNS stimulation to prevent a seizure. Seizure precautions provide environmental safety should a seizure occur.

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Option A: Because of edema, daily weight is important but not the priority. 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 C: Preeclampsia causes vasospasm and therefore can reduce uteroplacental perfusion. The client should be placed on her left side to maximize blood flow, reduce blood pressure, and promote diuresis.

Option D: Interventions to reduce stress and anxiety are very important to facilitate coping and a sense of control, but seizure precautions are the priority.

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