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Title: The perinatal nurse is caring for a woman at 26 weeks' gestation who has a history of hypertension ... Post by: Ieatbutt on Feb 6, 2018 The perinatal nurse is caring for a woman at 26 weeks' gestation who has a history of hypertension that has been well controlled. Today she presents with a blood pressure of 156/102 mm Hg and she has 2+ protein on urine dipstick.
Which initial action by the nurse is most appropriate? A. Arrange admission to the high-risk OB unit. B. Instruct the woman on strict bedrest. C. Obtain a clean-catch urine sample. D. Prepare to administer IV anti-hypertensives. Title: The perinatal nurse is caring for a woman at 26 weeks' gestation who has a history of hypertension ... Post by: jhfaipfipa on Feb 6, 2018 ANS: C
Preeclampsia can occur in a woman who has chronic hypertension. This woman has the characteristics of hypertension after a period of good control and proteinuria of at least 2+ on dipstick (100 mg/dL). The nurse needs to ensure protein levels are assessed in two samples at least 4 hours apart and ensure the woman has no signs of a urinary tract infection, as protein can occur in a sample of infected urine. The nurse should obtain a clean-catch urine sample to send to the laboratory for analysis. Asymptomatic UTI can occur in up to 11 of pregnant women, so assessing for signs and symptoms may not be accurate. The woman does not need admission to the high-risk OB unit, strict bedrest, or IV anti-hypertensives at this point. |