38-Year-Old Female with Preeclampsia
Ms. Johansen, 38, is 26 weeks pregnant with her first child. She was diagnosed with preeclampsia (see p. 1114) three weeks ago. Antihypertensive drugs (p. 724) and daily home care monitoring were initiated. However, her blood pressure is continuing to rise and is now 162/108 mm Hg. She complains of a constant headache, exhibits edema, and her urinalysis is positive for protein.
Her doctor has her admitted and orders further blood tests to assess Ms. Johansen's platelet level and liver function. "We may have to deliver because that’s the only cure for preeclampsia." she says to you during your clinical rotation in obstetrics. “But if we do, then the baby will have problems. It’s a tough decision because we have to balance both the mother's and the baby’s health.”
2. One of your fellow nurses says that preeclampsia is characterized by vasoconstriction. Does this make sense? Why or why not?
Want to see the full answer?
Check out a sample textbook solutionChapter 28 Solutions
HUMAN ANATOMY+PHYSIOLOGY-ACCESS(IAC)
Additional Science Textbook Solutions
HUMAN ANATOMY
Human Physiology
Laboratory Experiments in Microbiology (12th Edition) (What's New in Microbiology)
Laboratory Manual for Holes Human Anatomy & Physiology Fetal Pig Version
Genetic Analysis: An Integrated Approach (3rd Edition)
- N.H. is a 76-year-old male admitted to the hospital through the emergency department. He fell outside his home. It appears that he may have sustained a fracture to his left hip. He has a history of type 2 diabetes mellitus and has a 40 pack-year smoking history that is now complicated by chronic obstructive pulmonary disease. Data Collected (use only those that apply) Complains of excruciating pain and tenderness in left hip Pain not relieved with morphine BP 166/94 mmHg Diaphoretic and pale skin Respiratory rate 36; crackles, expiratory wheeze X-ray of left hip reveals extracapsular fracture Hematocrit 30%; hemoglobin 15g/dL; WBC 15,000/uL Discussion Questions: Considering the nursing process, list in order the steps in transferring patient from bed to chair post operatively.arrow_forwardM.H. is an 80-year-old Caucasian female who is married and lives with her spouse. She presents to your office today with her spouse, feeling “coocoo, I just don’t feel right.” Currently she is taking rosuvastatin prescribed by her cardiologist for hyperlipidemia and a daily 325 mg aspirin. She drinks 3–6 hard liquor drinks a day, 3–4 times a week in the evening, and has a 65-year smoking habit, currently smoking two packs per day (ppd). She has no known allergies. Past surgical history includes hysterectomy for a benign fibroid. Family history of breast cancer in three sisters, Type 2 diabetes and CVA in one sister, cancer of unknown origin in one brother. All siblings and parents are deceased. Her husband reports that she is hard of hearing. He feels that it is due to cerumen build-up in her ears. She refuses to have the buildup removed. Her husband is also worried about her memory—states that she “just does not remember things like she used to. She keeps asking me the same questions…arrow_forwardMr. Henry is a 50-year-old male who presents to the office for headaches. he has a known history of sinus infections when the seasons change, high blood pressure and depression. his medications include Lopressor 50mg, daily and Claritin 10mg daily. he has a family history significant for aneurysms and depression. His vitals are BP 196/86 right arm seated, HR 87 regular, RR 13, Temp 98 oral. What is a NANDA approved diagnosis you could give her?arrow_forward
- Ralph , is 5 months post congestive heart failure (CHF), he is... Ralph , is 5 months post congestive heart failure (CHF), he is confined to a wheel chair due to advanced peripheral neuropathy and foot drop. His care is managed at home by a family nurse practitioner (FNP) who visits once a week and as necessary. On one of her visits, the FNP notes that Ralph has developed a Grade 3 sacral decubitus ulcer, lower extremity edema, and dyspnea while sitting. He is also confused and not oriented to person, place or time. Questions 1. 2. What risk factors for tissue break down are present? Explain in detail, the cellular changes that led to the sacral decubitus, now with necrotic dermal tissue. (Hint: the etiology and pathogenesis of the ulcer from injury to cellular death)arrow_forwardM. J. is a 76-year-old woman who lives on the side of a very steep mountain. The home health nurse has visited her once a week for the last year. She has running water, electricity, and a coal stove with back-up oil heat for very cold winter nights. She uses the telephone for communication. She has diabetes mellitus, hypertension, hypothyroidism, and is in atrial fibrillation. She has never been in the hospital before. Her current medications include metformin (250 mg twice a day), losartan (50 mg/day), levothyroxine sodium (Synthroid) (50 mcg/day), digoxin (0.125 mg/day), furosemide (Lasix) (10 mg/day), aspirin (81 mg/day), simvastatin (20 mg/day), and warfarin (Coumadin) (4 mg/day, with 6 mg on Sundays). Allergies are to penicillin (hives) and to metoprolol (hypotension and dizziness). M. J. stopped smoking 5 years ago, but until then she smoked one-half pack a day. Last laboratory test results (1 week ago) were: hemoglobin A1C (Hgb A1C) 8.3, international normalized ratio (INR) 1.7,…arrow_forwardM. J. is a 76-year-old woman who lives on the side of a very steep mountain. The home health nurse has visited her once a week for the last year. She has running water, electricity, and a coal stove with back-up oil heat for very cold winter nights. She uses the telephone for communication. She has diabetes mellitus, hypertension, hypothyroidism, and is in atrial fibrillation. She has never been in the hospital before. Her current medications include metformin (250 mg twice a day), losartan (50 mg/day), levothyroxine sodium (Synthroid) (50 mcg/day), digoxin (0.125 mg/day), furosemide (Lasix) (10 mg/day), aspirin (81 mg/day), simvastatin (20 mg/day), and warfarin (Coumadin) (4 mg/day, with 6 mg on Sundays). Allergies are to penicillin (hives) and to metoprolol (hypotension and dizziness). M. J. stopped smoking 5 years ago, but until then she smoked one-half pack a day. Last laboratory test results (1 week ago) were: hemoglobin A1C (Hgb A1C) 8.3, international normalized ratio (INR) 1.7,…arrow_forward
- A 10-year-old boy with known HbSS disease presented to the Paediatric Emergency Department with a oneweek history of fever and severe pain in his right leg, severity 9/10 for the last two days. On examination:Pulse – 100 beats/min, BP – 110/70 mmHg, Capillary refill < 2sec and Respiratory rate – 20 breaths/ min. He has point tenderness anteriorly on proximal tibia. There is no joint swelling.X-ray of the affected limb shows marked periosteal elevation.His complete blood count is: Hb – 6.5 g/dL WBC 30 x 10 /L Plt – 120 x 10 /L with a reticulocyte count of 1%.Of the following the MOST appropriate management in this patient would bea. Ibuprofen, Cefotaxime and top-up transfusionb. Morphine, Ampicillin and hydration therapyc. Morphine, Cefotaxime and hydration therapyd. Morphine, Cefotaxime and top-up transfusionarrow_forwardA 24-year-old male presented with confusion, shortness of breath, and painful calves. It was reported by a friend that he had been lying on the floor for several hours. He was a known intravenous heroin and alcohol abuser. On examination he appeared dehydrated and cold (tem- perature 35°C); his pulse was 75/minute and blood pres- sure 110/70 mmHg. Intravenous injection sites were apparent. His urine was dark coloured. His chest was clear. Arterial blood gases were done in the casualty department and a blood sample was sent to the pathology department and gave the following results (reference ranges are given in brackets): Arterial blood pH PCO₂ PO₂ HCO3- Serum Sodium Potassium Creatinine Calcium Albumin Phosphate Creatine kinase C-reactive protein 7.276 4.82 KPa 12.7 kPa 18.0 mmol/L 138 mmol/L 7.6 mmol/L 236 μmol/L 1.66 mmol/L 32 g/L 2.43 mmol/L >140,000 U/L 73 mg/L (7.35-7.45) (4.7-6.0) (12.0-14.6) (24-29) (135-145) (3.8-5.0) (71-133) (2.10-2.55) (35-50) (0.87-1.45) (55-170) (<10) The…arrow_forward10:28 ull NCM 112 RLE Case Report A 32-year-old man was referred to the emergencies of our hospital because of a right lower limb critical limb ischemia. Past medical history included chronic alcoholism and a three- month history of bilateral intermittent claudication. He did not report any episode of superficial thrombophlebitis. He smoked about 10 cigarettes since the age of ten and 10 cannabis joints daily since the age of twelve. He had no other cardiovascular risk factors. At clinical examination, his right leg was extremely painful and pale. He had absent pedal pulses on both sides, and a mild sensory loss on the right side. Allen's test of upper extremities was negative. Echo Doppler was suggestive of a bilateral common iliac occlusion and of a three-vessel occlusion on the right leg. A computerized tomography (CT) angiography detected the presence of an intraluminal aortic and iliac clot and a bilateral ibial essels occlusion. The patient was fully anticoagulated with…arrow_forward
- What complications is Mr. E at risk for following general anesthesia and a below-the-knee amputation (BKA)? Please explain Note: -Mr. E is a smoker, has heart disease and diabetes type 1 as well as PVD -This is during the postoperative Phasearrow_forwardWhat would be the laxative of choice for a 1-year-old child? Why is this the best choice? What nursing considerations are necessary when using laxatives in children?arrow_forwardbriefly describe the pathophysiology of leukamia? Please correctlyarrow_forward