Lecture on Pre-Eclampsia: Prevention, Assessment, and Nursing Diagnosis

Introduction

• Presenter: Professor D
• Part of a multi-part series on pre-eclampsia.
• Focus on prevention, assessment, and nursing diagnosis.
• Encouragement to watch Part 1 for complete understanding.

Prevention of Pre-eclampsia

• Low-dose Aspirin Recommendation:
  • ACOG suggests daily low-dose aspirin (81mg) for high-risk women between 12 and 28 weeks of gestation.
  • Aim: Reduce pre-eclampsia and adverse outcomes.
• Risk Factors for Pre-eclampsia (Important for exams):
  • History of pre-eclampsia with adverse outcomes.
  • Multi-fetal gestation.
  • Chronic hypertension.
  • Pre-existing diabetes (Type 1 or Type 2).
  • Kidney disease.
  • Autoimmune disorders (e.g., lupus).

Assessment of Pre-eclampsia

• Blood Pressure Measurement:
  • Essential for early detection of hypertensive disorders.
  • Pre-eclampsia involves hypertension with proteinuria after 20 weeks gestation.
• Edema Assessment:
  • Not included in the definition but common.
  • Protein loss (albumin) leads to fluid in tissues, causing edema.
  • Pitting edema: Small depression persists after pressure is applied.
• Deep Tendon Reflexes (DTRs):
  • Reflect balance between cerebral cortex and spinal cord.
  • Baseline evaluation to detect changes.
  • Concern: Transition from pre-eclampsia to eclampsia (seizures).
  • Assessment of biceps and patellar reflexes.
  • Grading:
    • 0: No response.
    • 1+: Sluggish/diminished.
    • 2+: Active/expected (normal).
    • 3+: Slightly hyperactive.
    • 4+: Hyperactive with clonus.
• Proteinuria Assessment:
  • 24-hour urine collection preferred.
  • Proteinuria: ≥300mg or protein-creatinine ratio >0.3.
  • More accurate than dipstick testing.

Severe Features of Pre-eclampsia

• Severe headaches (frontal).
• Epigastric pain or right upper quadrant pain.
• Visual disturbances (scotoma, photophobia, double vision).

Nursing Diagnoses for Pre-eclampsia

• Common Nursing Diagnoses:
  • Anxiety.
  • Deficient knowledge.
  • Disabled family coping.
  • Powerlessness.
  • Risk for Injury:
    • Related to hypertension, CNS irritability.
    • Vaso-spasms causing decreased perfusion to the placenta and kidneys.
  • Risk for Impaired Fetal Growth:
    • Related to disrupted oxygen transfer.
    • Intrauterine Growth Restriction (IUGR), placental abruption, pre-term birth.

Conclusion

• Next video (Part 3) will cover nursing interventions for hypertension and pre-eclampsia.
• Encouragement for viewer interaction in comments to support channel growth.
• Mention of audio lessons available on nexusnursinginstitute.com.

Note: Make sure to understand the risk factors and nursing diagnoses as they frequently appear in examinations.