I.

INTRODUCTION

I.I BACKGROUND OF THE DISEASE

Pre-eclampsia, also referred to as toxemia, is a medical condition where

hypertension arises in pregnancy (pregnancy-induced hypertension) in association
with significant amounts of protein in the urine. Pre-eclampsia refers to a set of
symptoms rather than any causative factor, and there are many different causes for
the condition. Women with preeclampsia will often also have swelling in the feet,
legs, and hands. In addition symptoms of preeclampsia can include:

•Rapid weight gain caused by a •A change in reflexes

significant increase in bodily fluid •Reduced output of urine or no urine
•Abdominal pain •Dizziness
•Severe headaches •Excessive vomiting and nausea

Pre-eclampsia may develop from 20 weeks gestation. Its progress differs

among patients. Most cases are diagnosed pre-term. It may also occur up to six
weeks post-partum. It is the most common of the dangerous pregnancy
complications; it may affect both the mother and the unborn child. There are 2
categories of preeclampsia, mild and severe. Severe preeclampsia is defined as the
following:

•blood pressure greater than 160 mm Hg systolic or 110 mm Hg diastolic on 2

occasions 6 hours apart
•proteinuria exceeding 2 g in a 24- •epigastric pain
hour period or 2-4+ on dipstick testing •elevated liver enzymes
•increased serum creatinine (> 1.2 •thrombocytopenia (platelet count <
mg/dL unless known to beelevated 100,000/mm3)
previously) •retinal hemorrhages, exudates, or
•oliguria ≤500 mL/24 h 2 papilledema
•cerebral or visual disturbances •pulmonary edema

I.I I INCIDENCE/STATISTICS
 A database of hospital discharge data from approximately 300,000
deliveries in the United States found the overall incidence of severe preeclampsia
was about 1 percent of pregnancies. Studies of preeclampsia report about 5 percent
of nulliparous women develop preeclampsia and 40 to 50
percent of these women develop severe disease.

In the Philippines, according to Department of Health, Maternal Mortality Rate

(MMR) is 162 out of 10,000 live births (Family Planning Survey 2006). Maternal
deaths account for 14% of deaths among women. For the past five years all of the
causes of maternal deaths exhibited an upward trend. Preeclampsia showed an
increasing trend of 6.89%; 20%; 40%; and 100%. Ten women die every day in the
Philippines from pregnancy and childbirth related causes but for every mother who
dies, roughly 20 more suffer serious disease and disability. The UNFPA office in the
Philippines declared that family planning can help prevent maternal deaths by 35%.

I.III STUDENTS’ MOTIVATION IN CHOOSING STUDY

I.IV OBJECTIVES

Nurse-Centered Objectives

Upon completion of this case study, the student nurse should be able to:

1. Identify the risk factor contributing to the occurrence of the disease.

2. To gain new facts and ideas about the disease.

3. Identify the different medications administered for this disease their

indications, contraindications, side effect, and specific responsibility.
4. Identify the laboratory and diagnostic procedure done with the pre-eclamptic
patient, their indication and purposes, and specific nursing responsibilities.

5. Formulate related nursing diagnosis from the patients health data and to the
current problems the patient experiences and to come out with different
nursing interventions effective for the patient to improve and progress on the
most possible time.
 6. Set realistic objectives of care

Client-Centered Objectives

Upon completion of this case study, the client should be able to:

1. Understand awareness of her disease.

2. Know the possible causes of the disease.

3. Learn and understand why such laboratory examinations are being done.

4. Cooperate in necessary interventions and managements to be done.

II. ASSESSMENT

II.I NURSING HISTORY

a.) Demographic Data

Mrs. MB, a 28-year-old (occupation) mother of three, who currently

resides at( address with her extended family including her parents, brothers

and sisters and their family, also with her husband and children Mr. (name).

She was born on (birthday and birthplace).

b.) Socio-Economic and Cultural Factors

Mrs. MB is (occupation) and her husband is a/n (occupation). She

graduated (educational background).

 Mrs. Ob was raised as a Roman Catholic, were she learned about

religious values. When it comes in health matters, she usually goes to the

health center and refers to medical professionals for help.

c.) Environmental factors

Ms. MB resides at _______ and occupies the ancestry house of her

family. The location of their house is (not) easily accessible to hospitals,

health centers and other government institutions. Mrs. MB did not report any

problems regarding her environment which interfered to her pregnancy.

II.II PERSONAL DATA

II.III CHIEF COMPLAINT

The patient was admitted at a Regional Hospital with a chief complaint

of labor pain, (LMP: November 15, 2009; EDC: August 22, 2010; G2P2) last
August 20, 2010 at around 9:55 p.m.

II.IV HISTORY OF PRESENT ILLNESS

II.V PAST MEDICAL HISTORY