(Select all that apply) A nurse is assessing a client who is 32 weeks pregnant and has a diagnosis of severe preeclampsia.
Which of the following findings should the nurse report to the provider immediately?
Epigastric pain
Blurred vision
Facial edema
Hyperreflexia
Oliguria
Correct Answer : A,B,D,E
The correct answer is choice A, B, D and E. These are all signs of severe preeclampsia that indicate organ damage and require immediate medical attention. According to Mayo Clinic, preeclampsia is a complication of pregnancy that causes high blood pressure, protein in the urine, or other signs of organ damage after 20 weeks of gestation.
Choice A is correct because epigastric pain can indicate liver damage or bleeding in the abdomen due to preeclampsia.
Choice B is correct because blurred vision or light sensitivity can indicate brain damage or increased pressure in the skull due to preeclampsia.
Choice C is wrong because facial edema is a common symptom of normal pregnancy and does not necessarily indicate preeclampsia.
Choice D is correct because hyperreflexia can indicate nervous system damage or increased pressure in the skull due to preeclampsia.
Choice E is correct because oliguria can indicate kidney damage or decreased blood flow to the kidneys due to preeclampsia.
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Correct Answer is C
Explanation
Magnesium sulfate.Magnesium sulfate is thedrug of choiceto prevent and treat seizures in people with severe preeclampsia and eclampsia.It is an anticonvulsant medication that reduces the risk of eclampsia by 50%.
Choice A is wrong because hydralazine is a blood pressure medication that can lower blood pressure in people with preeclampsia or eclampsia, but it does not prevent seizures.
Choice B is wrong because nifedipine is another blood pressure medication that can lower blood pressure in people with preeclampsia or eclampsia, but it does not prevent seizures.
Choice D is wrong because diazepam is an anticonvulsant medication that was previously used to treat eclamptic seizures, but it has been replaced by magnesium sulfate as the preferred drug due to its better safety and efficacy.Diazepam can also cause sedation and respiratory depression in the mother and the fetus.
Normal ranges for blood pressure are below 140/90 mm Hg, for proteinuria are below 300 mg/24 hours, for platelet count are 150,000 to 450,000 per microliter, for liver enzymes are 7 to 56 units per liter for alanine aminotransferase (ALT) and 10 to 40 units per liter for aspartate aminotransferase (AST), and for magnesium levels are 1.5 to 2.5 mEq/L.
Correct Answer is B
Explanation
Serum creatinine of 1.2 mg/dL.This indicates a need for further evaluation because it is above the normal range of 0.6 to 1.1 mg/dL for women and suggests kidney impairment.Preeclampsia can affect the kidneys and other organs.
Choice A is wrong because a platelet count of 150,000/mm3 is within the normal range of 150,000 to 450,000/mm3.
Choice C is wrong because proteinuria of 1+ on dipstick is expected in mild preeclampsia.
Choice D is wrong because serum albumin of 3.5 g/dL is within the normal range of 3.4 to 5.4 g/dL.
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