Post Partum Pregnancy Induced Hypertension

POST PARTUM

PREGNANCY INDUCED

HYPERTENSION Group A3

Aramburo Guanzon

Capino Largo

Chan Paguirigan

Diron Rosadia

Fajardo Sonico

Vargas

INTRODUCTION

WHAT IS PREECLMAPSIA

OBJECTIVE OF THE

STUDY

This case study was designed to

complement the gained knowledge

from our experiences, peers and

clinical instructors. It will serve as

the backbone of our specific

studies, rather than serve as a

stand – alone sharing tool for our

knowledge.

The primary goal of this case study

was to expand our experienced

and learned knowledge and

discover rationales behind every

procedure, terms and even roots of

our chosen OB – WARD case.

SIGNIFICANCE OF STUDY

For the students:

•Students who will be reading

this case study will become

aware of the nursing

management as well as

pathophysiology of post partum

preeclampsia

For the clinical instructor

Clinical instructors that will view

this will have a better idea and

understanding of how students

understand cases assigned to them

and help add information onto their

learned experiences and

knowledge

For the faculty:

To display excellent understanding of

what we have learned, what we have

accomplished and what we strived to

understand while under the OB –

WARD. Also, this case study signifies

the importance of knowledge and

research to our daily activities as a

student nurse

PATIENT’S PROFILE

Biographical Data

Patient’s Name: M.D.R

Birthday: May 16, 1974

Birthplace: Quezon City

Age: 40 years old

Sex: Female

Present Place of Residence: #6 C6-A R.M.A Kalusya

St. Tatalon. Quezon City

Nationality: Filipino

Religion: Catholic

Languages/ Dialect Spoken: Tagalog

Marital Status History: Married

Occupation and Employment History: Housewife

Local or Foreign Travel (if any) : none

Sleep habits/ pattern: Irregular

Sleeping Time: 7am

Waking Time: 1pm

Handedness: Right

Eye Glasses: N/A

Reason for Glasses: N/A

Contact Lenses: N/A

Hearing Aid: N/A

Dentures: N/A

Dietary Habits/ Eating Pattern: 3 x a day and snacks

Particular Food Preference: gulay, gata and chopsuey

Exercise: Walking

Frequency/Week: 2 x a week

Duration: 15 mins

Alcohol/ Caffeine (Amount/Duration): none

Tobacco/ Drug Abuse (Amount/Duration): none

Living Environment: ( Type of house, No. of

Occupants, and Community Setting): Living with

parents

Source of Income: Husband

Current Medication: Celecoxin 200 mg 1tab (BID)

Cefuroxime (Elixime) 500mg/tab

(BID)

Irbesatran 150mg/tab Ob in PM

Wifedipine 30mg/tab Ob in AM

ADMISSION DATE: July 08, 2014

Obstetric History:

Menarche: at age of 13

AOG: 39 6/7 weeks

EDD: 08/20/14

Baby born: 07/08/14

Surgeries: had C.S last 2002

G2T1P1A0L2M0

Diagnostic results:

•+1 protenuria

(urinalysis)

•+ Edema- U.E and L.E

Medical Diagnosis

(Admitting diagnosis)Previous as for

non measuring fetal status, pre

eclampsia

(Final Diagnosis) Pregnancy Uterine

operative delivery via Emergency in

transverse Cervical Cesarean section

II for repeat E severe pre eclampsia

delivered a LFT boy

Nursing Diagnosis

Risk for injury

related to elevated

blood pressure

PAST HISTORY OF

ILLNESS

General Health: Relatively Good

Accidents or Injuries: None

Childhood Illness: None

Hospitalization: First time on this

case

PRESENT HEALTH

HISTORY

•The patient is a 40 year old G2P1 (1001), 36 3/7 weeks AOG by LMP.

•Last menstrual period (LMP) on October 13 2013. Patient went to the OB-GYNE OPD.

•Her last PNCU was on July 1 2014.

• She experienced many subjective

complaint such as dizziness.

• On the day of admission, patient went to

UERM for B.P examination. BP was

200/100 to 180/90. 160/80.

• After that Patient had her urinalysis and

with result with Protenuria. Then she was

advised for admission

B – There is tenderness in the breast.

U – Contracted

B – Not distended

B – Bowel sounds RLQ – 8 LUQ - 10

RUQ – 10 LLQ – 6

L – No lochia

E – Cesarian

S – 8:45am BP: 140/90 PR PR: 79

RR: 18 Temperature: 36.5°C

H – No homan signs (Negative Homan sign)

E – The client wished to be discharge as soon as possible

FAMILY HISTORY

HT HT

PHYSICAL ASSESSMENT

PATHOPHYSIOLOGY

NURSING CARE PLANS

NURSING MANAGEMENT

DRUG ANALYSIS

IRBESATRAN 150MG/TAB

OB IN PM (Administered drug)

CELECOXIN 200 MG 1TAB

(BID) (Administered drug)

CEFUROXIME (ELIXIME)

500MG/TAB (BID) (Administered drug)

NIFEDIPINE 30MG/TAB OB

IN AM (Administered drug)

Prescribed for:

Nifedipine is used for the treatment and

prevention of angina resulting from either an

increased workload on the heart (as with

exercise) or spasm of the coronary arteries.

It is used in the treatment of high blood

pressure, to treat abnormally fast heart

rhythms such as atrial fibrillation, and in the

prevention of episodes of rapid heart rhythm

originating from the atria of the heart.

•It also is used to dilate blood

vessels that go into spasm such

as those causing Raynaud's

phenomenon, a painful condition

of the hands caused by spasm of

the arteries supplying blood to the

hands.

MAGNESIUM SULFATE (Ideal Prescription drug)

AMLODIPINE 10 MG (Ideal Situational Drug)

Prescribed for:

• Chest pain or heart pain (angina) occurs because of

insufficient oxygen delivered to the heart muscles.

Insufficient oxygen may be a result of coronary artery

blockage or spasm, or because of exertion which

increases the need of the heart for oxygen in patients with

coronary artery narrowing (coronary artery disease or

atherosclerosis).

• Amlodipine is used for the treatment and prevention of

angina resulting from coronary spasm as well as from

exertion.

• Amlodipine also is used in the treatment of high blood

pressure.

Dosing

• The recommended starting dose of

amlodipine for children and adults is 2.5 to

5 mg once daily.

• The maximum dose for adults is 10 mg

once daily and the maximum dose for

children is 5 mg once daily.

• Amlodipine can be taken with or without

food. Amlodipine is inactivated mainly by

the liver, and dosages may need to be

lowered in patients with liver dysfunction.

Side Effects:

•Side effects of amlodipine are

generally mild and reversible. The two

most common side effects

are headache and edema(swelling) of

the lower extremities.

•Less common side effects include

dizziness, flushing, fatigue, nausea,

and palpitations.

FIN