Preeclampsia is a condition of pregnancy characterized by hypertension and proteinuria. It is common in women who are 20 years or older, with a 20% incidence. The pathophysiology of preeclampsia can be attributed to aberrant immunologic response, endothelial dysfunction and oxidative stress on the maternal vasculature leading to placental hypoperfusion with subsequent fetal hypoxia. Untreated preeclampsia may lead to eclampsia or HELLP syndrome; both conditions require hospitalization for treatment. Nursing interventions are necessary when a patient is admitted with preeclampsia because these measures will help prevent complications from occurring as well as provide education about care for this disorder during pregnancy

Nursing Intervention For Preeclampsia

1. Check the patient’s vital signs.

• Vital signs are a good way to assess the patient’s condition. Check blood pressure, pulse, respirations and temperature. If vital signs are elevated, you may need to intervene and treat for preeclampsia.
• If the patient is in pain, then vital signs will be elevated.

2. Check fluid balance.

• Monitor intake and output.
• Monitor weight.
• Monitor edema.

These interventions are typically done through nursing assessment, which is a process that nurses use to evaluate a patient’s signs, symptoms, and behaviors in order to identify any problems that may be occurring or developing in their health condition. Nursing assessments help nurses determine whether or not patients are getting the right medical care they need at any given time in order to ensure that they’ll get better as quickly as possible.

3. Assess urine output.

Urinary output is one of the best indicators of the progression of preeclampsia. Urinary output should be monitored closely and recorded in a chart by patients and their nurses. Several factors contribute to increased urinary output, including frequent voiding, low fluid intake, and lack of activity.

Other indicators that can help determine if your patient has preeclampsia include abdominal swelling (edema), proteinuria (urine that contains excess protein), hematuria (blood in the urine), frequency and volume of urination, oliguria (very small amount of urine output), loin pain or back pain.

4. Assess for headaches, blurred vision or other neurologic symptoms.

Headaches are a common symptom of preeclampsia and may be a sign of preeclampsia. If you experience headaches, it is important to report them as soon as possible so that we can closely monitor your condition.

5. Assess for epigastric pain, abdominal tenderness or pain in the right upper quadrant.

Assess for epigastric pain, abdominal tenderness or pain in the right upper quadrant.

• Abdominal pain may be present and localized to the epigastrium, which is located just below the sternum (breastbone). The patient may describe this as a diffuse ache or a sharp stabbing sensation.
• Palpate (feel) for rebound tenderness when you press on your abdomen lightly with your fingertips and then release suddenly. This can indicate underlying inflammation or internal bleeding into fatty tissue.
• You should also assess for lower back pain or shoulder tip pain that radiates down both arms; these signs suggest preeclampsia-related kidney failure.

6. Perform funduscopic exam for hypertensive retinopathy.

• Funduscopic exam for hypertensive retinopathy.
• Check for retinal hemorrhages, cotton-wool spots, papilledema (edema of the optic disc and visual field loss), arteriovenous nicking/narrowing, papillitis (inflammation of the optic disc), exudates and disc edema.
• Perform funduscopic exam in the setting of preeclampsia when there is evidence of hypertension or proteinuria

7. Monitor FHR, consider NST and BPP at admission and daily thereafter.

• Monitor FHR, consider NST and BPP at admission and daily thereafter.
• NST is a test that monitors the baby’s heart rate and fetal activity.
• BPP is a test that measures the amount of blood flow in the umbilical cord.

8. Report reduced fetal activity immediately.

If the patient reports reduced fetal activity, monitor the fetus by ultrasound. If you do not have access to ultrasound equipment, measure the fundal height and compare it to measurements from previous ultrasounds. Report altered fetal heart tones or reduced fetal activity immediately (i.e., within 30 minutes).

9. Nursing interventions are necessary when a patient is admitted with preeclampsia.

• Nursing interventions are necessary when a patient is admitted with preeclampsia.
• Nursing interventions may include the following:
• Monitoring vital signs and weight daily
• Checking for edema and administering antihypertensive medications as prescribed by the physician

Closing

Nursing interventions for preeclampsia are meant to monitor the patient. This is important because this condition can be fatal if not treated properly. Nursing interventions such as checking vital signs, fluid balance, urine output, neurologic symptoms and others help the nurse keep track of how well the patient is doing during their stay in the hospital.