Essay on Complex Case Of Pregnancy

Added on - 23 Feb 2020

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Essay on a complex case of pregnancy1Essay on a complex case of pregnancyStudent's Name:Instructor's Name:Date:
Essay on a complex case of pregnancy2Essay on a complex case of pregnancyIntroduction:Perinatal care involves an important aspect of midwifery. Midwives working in asetting of primary health care, pregnancy or birthing units, and neonatal or perinatalcare units are required to have the necessary skills and technical knowledge ofcomplications during pregnancy and the medical care procedures to avoid problemspertaining to pregnancy(Aksornphusitaphong & Phupong, 2013). The primaryresponsibilities of the midwife include the assessment, diagnosis, and appropriatenursing care management of pregnant women. One of the primary and mostcommon complications in pregnancy is pre-eclampsia and hypertensive disorders.Additionally, the mortality rate of mothers with hypertensive disorders is high(Stellenberg & Ngwekazi, 2016).Pre-eclampsia is additionally called toxaemia and is characterised by the elevation inthe levels of blood pressure in pregnant women. Pre-eclampsia is a type ofhypertensive disorder and is found to be responsible for approximately 8% mortalityin pregnant women. The complication of pre-eclampsia during pregnancy commonlydevelops during the third trimester of pregnancy and is less commonly encounteredin the gestational period (English, Kenney, & McCarthy, 2015). The risk factors forthe development of pre-eclampsia during pregnancy are varied and range acrossmultiple elements such as nulliparity, obesity, chronic diabetes, medical history in thefamily, or donation of ova(Buhimschi et al., 2014).The current article discusses a case study of complication of pre-eclampsia duringpregnancy, the pathophysiology of the disease, midwifery and nursing care in
Essay on a complex case of pregnancy3pregnant women with pre-eclampsia, and the role of the midwife in pregnancy andprenatal pre-eclampsia therapy protocol (Stellenberg & Ngwekazi, 2016).Case-study:Clara Turner is a 32-year-old housewife. She is a first-time mother. She current liveswith Richard Turner, her husband, in Clermont, Queensland. Clara presented to thehospital complaining of severe pain in the abdomen, last week. Clara is a housewifeand Richard works on the family farm. Clara does not have a medical history of highblood pressure or diabetes. Clara’s trimestral records in pregnancy show striaegravidarum, melasma, and lineanigra. She additionally complained of headache andnausea frequently. The patient has a medical history of hypertension on her paternalfamilial side i.e. both her paternal grandmother and father had hypertension. Claraexperiences anxiety and restlessness. Her medical examination shows borderlineobesity and raised blood pressure. Clara was diagnosed with pre-eclampsia. Clarahas been rapidly putting on weight ever since her first presentation, has dizzinessand headaches frequently, and has excessive instances of nausea. Uponexamination, it was found that the urine output is decreased and her neurologicalreflexes and orientation are slightly hindered.Pre-eclampsia – pathophysiology and disease mechanism:Pre-eclampsia belongs to the large spectrum of diseases associated withhypertension and is commonly found in pregnant women during the third trimester ofpregnancy (Mustafa, Ahmed, Gupta, & Venuto, 2012).It has a high aetiology rate andis one of the most common complications ofpregnancy. The pathogenesis and thedisease mechanism is relatively unknown in research. The hypertension that is foundin pregnant women with pre-eclampsia has several harmful or adverse effects on the
Essay on a complex case of pregnancy4foetus and the mother.The development of pre-eclampsia generally occurs duringthe twentieth week of pregnancy or during the childbirth. The condition can last up tothe postpartum stage of 48 hours (Ferreira, Silveira, Silva, Souza, & Ruiz, 2016).Pre-eclampsia is one of the broad spectrum of diseases belonging to thepathobiology of hypertensive disorders during pregnancy(Direkvand-Moghadam etal, 2012). The other disorders include: chronic hypertension, gestationalhypertension, and pre-eclampsia (Ferreira et al., 2016). The determination of pre-eclampsia in pregnancy is primarily done by means of measurement of bloodpressure values. The value of 140/90 mm Hg or higher value of blood pressure(diastolic pressure of 140 mmHg and systolic value of 90 mmHg) indicate thepresence of pre-eclampsia in pregnancy.Pathogenesis of the disease:The physiological observations of the diseaseinclude the presence of several significant modifications in the vascular system ofthe patient(Guerrier et al., 2013).The systemic blood flow and vascularhemodynamic characteristics are greatly altered in the disease condition(Mustafa etal., 2012). The alterations are found in the prenatal stages. These changes may beappreciated upon inspection and physical examination(Shegaze et al., 2016). Thereare observable changes in the systolic and diastolic blood pressurevalues(Direkvand-Moghadam et al, 2012). The increase in the level of diastolicpressure is higher as compared to the diastolic pressure values. The alterations areseen during the 20thweek of pregnancy and the values may be higher than 140mmHg. The systemic values of blood pressure and the vascular blood flow alsoincrease accordingly. These changes are accompanied by elevation in the levels ofcardiac output (Mustafa et al, 2012). The peak threshold value of blood pressure and
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