Posted: December 5th, 2022
Nursing Interventions in Pregnancy-Induced Hypertension.
Nursing Interventions in Pregnancy-Induced Hypertension
Nursing Interventions during Pregnancy
• Educate the woman to exercise because it reduces excessive gestational weight gain and the risk of hypertension
• Encourage the woman to have adequate rest to lower the blood pressure in order to increase the flow of blood to the placenta
• Monitor the blood pressure closely to ensure that the blood pressure does not increase to dangerous levels.Nursing Interventions in Pregnancy-Induced Hypertension.
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• Encourage the woman to have bed rest be in a recumbent position to promote sodium secretion
• Ensure good nutrition
• Provide emotional support and allow the woman to speak out her fears
Nursing Interventions During Labor
• Constant fetal monitoring
• Control environmental stressors for the mother
• Frequently update the mother and the family to avoid anxiety
• Provide the woman with emotional support to reduce the anxiety that could worsen hypertension
Nursing Interventions during the Postpartum Period
• Manage expectations of the mother and prepare her for an alternative outcome
• Provide the mother with emotional support because it might be a difficult period when the infant is in the neonatal unit
• Continue monitoring the blood pressure for the mother
• Educate the mother on the importance of adhering to the antihypertensive medication post-delivery
• Control and manage postpartum pain effective using the prescribed analgesics (Cairns et al., 2017)Nursing Interventions in Pregnancy-Induced Hypertension.
Pathophysiology of Postpartum Thromboembolic Disorders and DVT
During pregnancy, proteins with the coagulation system are significantly affected and particularly the fibrinogen levels significantly increase during pregnancy. Protein S levels reduce during pregnancy. The coagulation changes increase the likelihood of thrombus formation. Postpartum, the parameters of the coagulation factors may fail to return to normal leading to the risk of thrombus formation. In addition, during pregnancy, stasis occurs where there is a significant impact on the return of blood from the lower extremities (Kotaska, 2018). This hinders the return of the blood via the inferior vena cava and there is also increased pressure and stasis. However, in postpartum thromboembolic disorders, vascular trauma during childbirth is the most likely cause.Nursing Interventions in Pregnancy-Induced Hypertension.
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Antepartum measures to decrease risk of thromboembolic disease in childbearing women
Advice woman to exercise “walking is ideal
Recommended plenty of fluid to avoid dehydration
Advice to quit smoking
Avoid prolonged standing or sitting in one position or sitting with leg crossed
Encourage elevation of legs when sitting
Avoid tight knee –high hose or other constrictive garments .
Encourage to take frequent breaks during long car trips to walk around to prevent prolonged venous stasis.Nursing Interventions in Pregnancy-Induced Hypertension.
Intrapartum measures to decrease risk of thromboembolic disease in childbearing women
Encourage ambulation unless contraindicated in early labor
Encourage leg exercises “ late labor”
Do not gatch bed or use pillows under knees
Ensure correct positioning in stirrups that minimizes pressure on popliteal area
Limit time in stirrups’ as possible
Initiate leg and foot exercise after cesarean birth
Use anti-embolism stocking for women at risk of deep vein thrombosis
Postpartum measures to decrease risk of thromboembolic disease in childbearing women
Encourage early ambulation
For women on bed rest ,advise or assist with turning &leg exercise every 2 hours
Encourage fluids to avoid dehydration
Advise no smoking
Use anti-embolism stockings with those at risk
Pneumatic compression stockings may be ordered after cesarean birth until ambulation occurs.
Advise against prolonged sitting and crossing legs
Avoid knee gatch in hospital bed
Encourage elevation of legs while sitting
Nursing Interventions in Pregnancy-Induced Hypertension During Pregnancy, Labor, and the Postpartum Period
Nursing Interventions in pregnancy-induced hypertension are basically holistic and center on moral support, psychological support, and health education. During pregnancy, some of the nursing interventions include constant blood pressure monitoring to ensure that the blood pressure is not rising to dangerous levels.Nursing Interventions in Pregnancy-Induced Hypertension. The others are psychological support and counselling for the mother to allay her fears about what may happen to her and her unborn baby. This is holistic nursing care. The nurse will also advise the mother to rest as much as possible. If possible, this should be complete bed rest. This will help lower the blood pressure. Also, advise on a low salt diet will be very important. All this will be done as the nurse continuously and closely monitors the pregnant mother’s blood pressure. In the event that the nurse notices that the blood pressure is rising to very high levels, on of the other very important interventions is to refer the mother for further more aggressive care.
During labor, the most important intervention by the nurse is psychological support through talking to the mother and keeping her from developing intense anxiety, which only worsens the hypertension. Post-partum, the nurse counsels the mother about being prepared psychologically for a possible prolonged stay in the neonatal intensive care unit for the newborn.Nursing Interventions in Pregnancy-Induced Hypertension.
On post-partum thromboembolic disorders, the pathophysiology involves stasis of blood in the lower limb veins whivh encourage clotting. Pregnancy itself has the effect of making clotting easier. But the usual trigger for a clot which then dislodges and causes an embolism is vascular trauma from delivery. Sometimes, this causes multiple clots as a result of disseminated intravascular coagulation or DIC.Nursing Interventions in Pregnancy-Induced Hypertension.
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