A nurse is caring for a client with mild pre-eclampsia who has a blood pressure of 150/95 mmHg, proteinuria of 400 mg/24 hours, and edema of the face and hands.
Which intervention is the priority for this client?
A. Administer magnesium sulfate as prescribed
B. Monitor the fetal heart rate and movement
C. Encourage bed rest in a left lateral position
D. Educate the client about the signs of eclampsia
The correct answer and Explanation is :
The correct answer is C. Encourage bed rest in a left lateral position.
Explanation:
Pre-eclampsia is a condition characterized by hypertension, proteinuria, and often edema, typically occurring after 20 weeks of pregnancy. In mild pre-eclampsia, as seen in this client, the primary concern is controlling blood pressure and ensuring the well-being of both the mother and the fetus.
Encouraging bed rest in a left lateral position is a priority intervention in mild pre-eclampsia for several reasons:
- Improved blood flow to the placenta: The left lateral position helps to improve blood circulation by reducing pressure on the major blood vessels, such as the inferior vena cava. This helps improve blood flow to the uterus and placenta, enhancing oxygen and nutrient delivery to the fetus.
- Lowering blood pressure: By resting in this position, maternal blood pressure can decrease, which is critical in pre-eclampsia management to prevent progression to severe pre-eclampsia or eclampsia. Although the client’s blood pressure is elevated at 150/95 mmHg, it is not yet critically high (≥160/110 mmHg), so non-pharmacological interventions are important.
While A. Administering magnesium sulfate is a key intervention in preventing seizures in severe pre-eclampsia or eclampsia, it is not yet indicated for mild pre-eclampsia. Magnesium sulfate is generally prescribed when the risk of seizures is higher.
B. Monitoring fetal heart rate and movement is essential but secondary to stabilizing the maternal condition. Addressing maternal blood pressure is more immediate in this case.
Finally, while D. Educating the client about the signs of eclampsia is important for prevention, it does not take precedence over the need for immediate physical measures like bed rest to reduce blood pressure and promote placental blood flow.