, NUR1211C: Preeclampsia-Eclampsia RAPID Reasoning,Dana Myers, 40
years old (Answered)
RAPID Reasoning Case Study: STUDENT
Preeclampsia-Eclampsia
History of Present Problem:
Dana Myers is a 40-year-old woman, G-3 P-2 who is 34 weeks gestation. Her health care provider has been monitoring
her weekly because her blood pressure has been increasing the past month and is currently 146/88. Last week she had
1+ non-pitting edema of both lower extremities (BLE) and her urine was negative for protein. Today during her clinic
visit, Dana’s BP was 168/90. She had 2+ proteinuria and 3+ pitting edema BLE. She also complained of a mild
headache in the center of her forehead, and seeing “spots.” Fetal heart tones via Doppler are 136/minute in the lower left
quadrant.
Abdominal measurement from pubic bone to top of fundus is 31 cm.
The primary care provider was concerned and Dana has been admitted to the community hospital labor and delivery
unit to be evaluated for severe preeclampsia. You are the admitting nurse responsible for her care.
Personal/Social History:
Dana has two children, ages two and four. She is married and both she and her husband are excited to have another
baby, but have been concerned about this pregnancy. Dana’s previous two pregnancies were healthy, without incident,
resulting in the vaginal births of a boy, then a girl. Dana’s parents live in the same town and are supportive.
Dana works part-time teaching English at the local community college. Her husband is an engineer who works full
time and is occasionally out of town for work. Dana is generally healthy, without any chronic illnesses. She does not
smoke or use recreational drugs. She reports drinking socially but refrains while pregnant.
What data from the histories are RELEVANT and has clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Increasing blood pressure. These are all manifestations of preeclampsia.
+2 proteinuria
Pitting edema BLE
Mild headache in the center of forehead and
seeing spots.
RELEVANT Data from Social History: Clinical Significance:
Two children ages 2 and Dana already has two younger children, which could be stressful with
4. Married. being pregnant and having complications. With Dana being married and
Parents live in same town. having her parents living in the same town, shows that she has a good
Part-time teaching support system. Dana works part-time and her husband is an engineer, so
English. they are financially stable.
Husband engineer.
Patient Care Begins:
Current VS: P-Q-R-S-T Pain Assessment (5th VS):
T: 98.4 F/36.9 C (oral) Provoking/Palliative: None
P: 84 (regular) Quality: Stabbing/throbbing
R: 20 (regular) Region/Radiation: Eyes, forehead
BP: 164/98 Severity: 5/10
O2 sat: 95% room air Timing: Constant, unrelieved by acetaminophen
What VS data are RELEVANT and must be recognized as clinically significant by the nurse?
RELEVANT VS Data: Clinical Significance:
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