Client Background: Cari Thomas is a 39-year-old G-1, P-0 female client who has been admitted to Labor and Delivery this afternoon due to worsening features of mild preeclampsia at 35 weeks. The client was at a routine prenatal visit with her provider just an hour ago, and it was discovered that her blood pressure and neurological symptoms have worsened. The provider is anticipating confirmation of a diagnosis of severe preeclampsia. The client has a history of obesity and heart disease with hyperlipidemia. Her history is negative for gestational diabetes. The client has her husband at the bedside for support.
You perform an assessment on Cari. The results are as follows:
• Vitals: 172/98, 104, 20, 95% RA, 98.4 F
• A&O x4
• c/o headache (5 on pain scale for the past 3 days)
• Blurry vision in the left eye
• Lung sounds clear bilaterally
• Heart sounds strong
• Bowel sounds active x4
• 3+ edema bilateral upper and lower extremities
• Facial puffiness
• Reflexes upper and lower +4/ negative clonus
• Denies RUQ pain/Denies epigastric pain
• Skin color is appropriate for ethnicity, warm/dry
7. Cari has an NST and BPP the next morning, and the results come back reassuring, with a BPP score of 6/10. What do these results mean, and what do you anticipate happening next in the plan of care?
8. Cari’s BP continues to increase, and her last reading was 182/110, even with the nifedipine and magnesium on board. The physician decides that it is time to deliver Cari’s baby. What are important factors to consider when deciding how Cari should deliver?
9. If Cari is cleared to be medically induced at this time, what medications might be ordered for this induction? What is important to consider regarding this induction of labor and her current health status/diagnosis?
10. Cari delivers a healthy baby girl vaginally after 27 hours of labor. Describe the postpartum management of preeclampsia.