NCP Gestational Hypertension

ASSESSMENT DIAGNOSIS INFERENCE PLANNING INTERVENTIONS RATIONALE EVALUATIONS
Independent
Objective: Impaired Tissue Nursing care for PIH Do a nonstress test 1.Present information 1.Decrease in placental blood Patient
T: 37.5 Perfusion involves providing (NST), Biophysical to patient/couple flow results in reduced gas demonstrates
P: 75 related to adequate nutrition, profile and, Doppler concerning home exchange and impaired normal CNS
R: 13 maternal good prenatal care, flow studies to the assessment or noting nutritional functioning of the reactivity on
BP: 100/80 hypovolemia in and control of pre- check both the daily fetal movements placenta. Potential outcomes nonstress test
-clammy skin relation with existing patient and the and when to seek of poor placental perfusion (NST)
- Pale skin Intrauterine hypertension during baby. immediate medical include a malnourished, LBW
growth pregnancy decrease attention. infant, and prematurity Patient is free of
Subjective: retardation the incidence and associated with early delivery, late deceleration
The patient severity of 2. Name factors abruptio placentae, and fetal
felt nausea, preeclampsia. Early affecting fetal activity. death. Reduced fetal activity Patient has no
and recognition and means fetal compromise decrease in FHR on
generalized prompt treatment 3. Report signs of (occurs before detectable contraction stress
weakness of preeclampsia can vaginal bleeding, alteration in FHR and indicates test/oxytocin
prevent progression uterine tenderness, demand for immediate challenge test
to eclampsia. abdominal pain, and evaluation/intervention. (CST/OCT).
decreased fetal activity
2. Cigarette smoking,
4. Evaluate fetal growth; medication/drug use, serum
measure progressive glucose levels, environmental
fundal accompany sounds, time of day, and
growth at each office sleep-wake cycle of the fetus
visit or periodically can increase or decrease fetal
during stress home movement.
visits, as appropriate.
3. Immediate attention
5. Check FHR manually and intervention increases
or electronically, as the likelihood of a positive
indicated.
outcome.
6. Note fetal response
4. Reduced placental
to medications in
functioning may accompany
direction of the doctor
PIH, resulting in IUGR. Chronic
such as MgSO4,
intrauterine stress and
phenobarbital, and
uteroplacental insufficiency
diazepam.
decrease amount of fetal
Dependent
contribution to amniotic fluid
7. Assess fetal response pool.
to BPP criteria or CST, as
maternal status 5. Helps evaluate fetal well-
indicates. being. An elevated FHR may
show a compensatory
8. Assist with response to hypoxia,
assessment of fetal prematurity, or abruptio
maturity and well-being placentae.
using L/S ratio, presence
of PG, estriol levels, 6. Depressant effects of
FBM, and sequential medication reduce fetal
sonography beginning respiratory and cardiac
at 20–26 weeks’ function and fetal activity
gestation. level, even though placental
circulation may be adequate.
9. Assist with
assessment of maternal 7. BPP helps evaluate fetus
plasma volume at 24–26 and fetal environment on five
weeks’ gestation using specific parameters to assess
Evans’ blue dye when CNS function and fetal
indicated. contribution to amniotic fluid
volume. CST assesses
10. Utilizing an placental functioning and
ultrasonography, assist reserves.
with assessment of
placental size. 8. In the event of declining
maternal/fetal condition, risks
11. Give corticosteroid of delivering a preterm infant
(dexamethasone, are weighed against the risks
betamethasone) IM for of continuing the pregnancy,
at least 24–48 hr, but using results from evaluative
not more than 7 days studies of lung and kidney
before delivery, when maturity, fetal growth, and
severe PIH necessitates placental functioning. IUGR is
premature delivery associated with reduced
between 28 and 34 maternal volume and vascular
weeks’ gestation. changes.
9. Identifies fetus at risk for

IUGR or intrauterine fetal
demise associated with
reduced plasma volume and
reduced placental perfusion.
10. Reduced placental

function and size are
associated with PIH.
11. Corticosteroids are

thought to induce fetal
pulmonary maturity
(surfactant production) and
prevent respiratory distress
syndrome, at least in a fetus
delivered prematurely
because of condition or
inadequate placental
functioning. Best results are
obtained when fetus is less
than 34 weeks’ gestation and
delivery occurs within a week
of corticosteroid
administration

NCP Gestational Hypertension

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What are some factors that can affect fetal movement?

What assessments are done to evaluate fetal well-being and growth?

ASSESSMENT DIAGNOSIS INFERENCE PLANNING INTERVENTIONS RATIONALE EVALUATIONS

9. Identifies fetus at risk for

10. Reduced placental

11. Corticosteroids are

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