im trying to complete nursing diagnosis for my lady who has preeclampsia i need priorty dx i have decicent fluid volume r/t protein loss, vomiting as evidence by 3 plus protein loss and emsis on 240cc i feel i need one with blood pressure but alls i can find for a dx is in effecive cerebral tissue perfusion but i cant get it to fit.
The Correct Answer and Explanation is :
For a patient with preeclampsia, a priority nursing diagnosis related to high blood pressure would likely be Ineffective Tissue Perfusion: Cerebral, R/T hypertension, as evidenced by elevated blood pressure, blurred vision, and headache. This is because preeclampsia is characterized by hypertension that can impair cerebral blood flow, potentially leading to complications like cerebral edema, stroke, or visual disturbances.
Explanation:
Preeclampsia is a hypertensive disorder of pregnancy, typically diagnosed after 20 weeks of gestation, and is marked by high blood pressure and proteinuria. This condition can significantly affect maternal health by disrupting normal tissue perfusion, especially in the brain, kidneys, and liver. The elevated blood pressure in preeclampsia causes vasospasm (narrowing of the blood vessels), which leads to a decrease in perfusion to vital organs, including the brain. If untreated, this can progress to eclampsia, which is associated with seizures.
The Ineffective Tissue Perfusion: Cerebral diagnosis fits because the increased blood pressure in preeclampsia can lead to cerebral hypoxia or ischemia. Common symptoms like severe headaches, blurred vision, and a change in mental status can signal reduced cerebral perfusion, which is a priority concern for your patient. These signs of compromised cerebral perfusion warrant close monitoring, as they can lead to more severe complications, including stroke.
For Fluid Volume Deficit related to protein loss and vomiting, the diagnosis you proposed is appropriate but secondary to the concerns related to high blood pressure and cerebral perfusion. The proteinuria in preeclampsia suggests kidney dysfunction and potential fluid imbalance, but the immediate risk posed by impaired cerebral perfusion requires priority intervention.
In summary, Ineffective Tissue Perfusion: Cerebral takes precedence due to the potential for life-threatening complications like stroke or seizures in preeclampsia, but fluid volume issues are important to address as part of the overall care plan.