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Nursing mind map for women with complications during pregnancy
This is a mind map about the care of women with complications during pregnancy. This mind map can help you become familiar with the key points of knowledge and enhance your memory. Students in need can save it.
Edited at 2024-11-27 14:20:11- 12. L'ascesa della democrazia nazionale in Asia, Africa e America Latina
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Nursing mind map for women with complications during pregnancy
- 12. L'ascesa della democrazia nazionale in Asia, Africa e America Latina
Lezione 12 della storia, l'ascesa della democrazia nazionale in Asia, Africa e America Latina, questa mappa del cervello ti aiuta a familiarizzare con i punti chiave della conoscenza e rafforzare la memoria. Gli studenti bisognosi possono aggiungere un segnalibro.
- Chat gpt che inizia a padronanza
Questa è una mappa mentale sull'introduzione alla competenza di Chat GPT.
- SUGGERIMENTI DI UTILIZZO DI CHEAT
Questa è una mappa mentale sulla condivisione di profonde abilità di utilizzo.
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- Outline
Hypertensive disorders of pregnancy
Conditions specific to pregnancy, including gestational hypertension, preeclampsia, eclampsia, chronic hypertension complicated by preeclampsia, and pregnancy complicated by chronic hypertension
Cause
Predisposing factors
etiology
immune theory
Inadequate recasting of uterine spiral arterioles
endothelial dysfunction
Nutritional deficiencies and other factors
Pathophysiology
The basic pathophysiological change is systemic arteriolar spasm
Clinical manifestations and classification
Hypertension during pregnancy
First hypertension after 20 weeks of pregnancy, BP ≥ 140/90mmHg, and returns to normal within 12 weeks after delivery; urine protein (-); the patient may be accompanied by upper abdominal discomfort or thrombocytopenia
preeclampsia
Mild
After 20 weeks of pregnancy, BP ≥ 140/90mmHg; urine protein ≥ 0.3g/24h or random urine protein ( ); may be accompanied by upper abdominal discomfort, headache, blurred vision and other symptoms
Severe
BP ≥ 160/110mmHg; urine protein ≥ 2.0g/24h or random urine protein ≥ ( ); serum muscle > 106umol/L, platelets < 100×10^9/L; microvascular hemolysis (increased LDH); serum ALT or Elevated AST; persistent headache or other cranial nerve or visual disturbance; persistent epigastric discomfort
Eclampsia
Convulsive seizures or coma may occur on the basis of preeclampsia. Eclampsia is divided into prepartum eclampsia, intrapartum eclampsia, and postpartum eclampsia, with prepartum eclampsia being the most common.
Chronic hypertension complicated by preeclampsia
Pregnant women with high blood pressure have no proteinuria before 20 weeks of gestation. If urine protein ≥0.3g/24h or random urine protein ≥ ( ) appears after 20 weeks of pregnancy; or if urine protein suddenly increases after 20 weeks of pregnancy, blood pressure further rises, or Thrombocytopenia (<100x10^9/L).
Pregnancy complicated by chronic hypertension
Blood pressure ≥140/90mmHg before pregnancy or before 20 weeks of pregnancy, but not significantly aggravated during pregnancy; or hypertension is first diagnosed after 20 weeks of pregnancy and continues beyond 12 weeks postpartum.
nursing assessment
health history
Ask whether there are high-risk factors for hypertension during pregnancy; whether there is a history of hypertension, chronic nephritis, diabetes, etc.; whether there is high blood pressure, proteinuria, edema, headache, visual impairment, epigastric discomfort, convulsions, etc. during this pregnancy. symptom.
physical condition
Typical symptoms include hypertension, proteinuria, and edema. Conscious symptoms, convulsions, coma and other conditions; assess whether there are complications.
psycho-social condition
Diagnostic points
Routine urine examination
blood test
Liver and kidney function test
Fundus examination
When the disease is severe in the early stages, the small arteries under the eyes spasm, and the ratio of arterial and venous diameters changes from the normal 2:3 to 1:2 or even 1:4.
Treatment points
Should be hospitalized. The principles of treatment are antispasmodic, sedative, antihypertensive, reasonable volume expansion and diuresis, and timely termination of pregnancy to prevent complications. Magnesium sulfate is the first choice for antispasmodic treatment. If preeclampsia does not improve significantly after 24 to 48 hours of active treatment, the pregnancy should be terminated in time. Patients with eclampsia should quickly control the extraction, correct hypoxia and acidosis, and terminate the pregnancy 2 hours after the extraction is controlled.
Nursing measures
general care
Strengthen rest: rest for at least 10 hours a day, preferably in the left lying position.
Reasonable diet: Adequate intake of protein and calories, no restriction on salt and fluids, but salt intake should be appropriately limited for patients with generalized edema.
Reasonable use of sedatives: Give appropriate sedatives as directed by your doctor.
Intermittent oxygen inhalation: Intermittent oxygen inhalation as directed by the doctor.
Closely monitor the status of mother and child: strengthen prenatal examinations, pay attention to pregnant women's subjective symptoms, and measure weight and blood pressure every day. Regularly monitor fetal development and placental function, guide pregnant women to count fetal movements every day, and listen to fetal heartbeat frequently.
Magnesium sulfate medication care
Usage: Use slow intravenous infusion or deep intramuscular injection, and follow the doctor’s instructions to use the medication correctly.
Toxic reactions: First, the knee reflex weakens or disappears
Things to note
① Knee reflex exists. ② Breathing ≥16 times/minute. ③Urine output ≥17 ml/h or ≥400ml/24h. ④ 10% calcium gluconate is available. Once a poisoning reaction occurs, stop the drug immediately and inject 10 ml of 10% calcium gluconate intravenously.
Care of patients with eclampsia
Control convulsions: magnesium sulfate is the drug of choice
Avoid stimulation that may induce convulsions
Place the patient in a single dark room, keep quiet, and avoid sound and light stimulation. All nursing operations should be relatively concentrated and gentle to avoid inducing convulsions.
Special care by dedicated personnel to prevent injuries
Keep the airway open and inhale oxygen. Comatose patients should avoid eating and drinking, and turn their heads to one side to prevent suffocation or aspiration pneumonia. When a convulsion occurs, add a bed block beside the bed to prevent falling injuries. Use an opener or a tongue depressor and tongue forceps wrapped with gauze to place it between the upper and lower molars and fix the tongue to prevent lip and tongue bites or tongue falling backwards to block the airway.
Close supervision
Pay close attention to blood pressure, pulse, respiration, body temperature and urine output, record intake and output, and early detect and deal with complications such as cerebral hemorrhage, pulmonary edema, and acute renal failure.
Be prepared to terminate your pregnancy
Termination of pregnancy may be considered 2 hours after eclampsia is controlled.
Intrapartum and postpartum care
Vaginal delivery patients need to strengthen care during each stage of labor and shorten the second stage of labor as much as possible. In order to avoid maternal exertion, first-time mothers may consider assisted vaginal delivery. Postpartum blood pressure still needs to be monitored. Severe patients still have the possibility of postpartum eclampsia, and magnesium sulfate treatment should be continued. 1 to 2 days; mothers who use large amounts of magnesium sulfate are prone to uterine atony after delivery, and should closely observe the involution of the uterus to prevent postpartum hemorrhage.
psychological care
health education
Supplement 1~2g of calcium daily starting from the 20th week of pregnancy; try to choose a second pregnancy one year after normal blood pressure to prevent recurrence of the disease.
Common Nursing Diagnoses/Problems
Too much body fluid
It is related to the inferior vena cava being compressed by the enlarged uterus, which blocks blood return, or is related to malnutrition and hypoalbuminemia.
Risk of injury to mother and child
associated with eclampsia
potential complications
placental abruption