Page 183 - Critical Maternity & Newborn Health Nursing

>1+ dipstick test (if hypertension is present along with protein in the urine

the physician may order the woman to complete a 24-hour urine)

24-hour urine: >300 mg

>0.3 mg/dL creatinine to protein ratio

Other prenatal labs that may be ordered: CBC (platelets <100,000, red

blood cells or peripheral smear to check for hemolysis, creatinine, BUN),

liver enzymes (AST or ALT). If preeclampsia suspected.

Reflexes hyperactive (deep tendon reflexes…patellar and bicep)

- Watch for exaggerated reflexes called “hyperreflexia” like 4+.

- Indicates the CNS is stressed out and at risk for a seizures: assess

neuro status, vision changes, headaches, ankle clonus (check out the

lecture to see how to check for this).

- Magnesium Sulfate may be ordered to decrease the risk of seizure

activity: Watch for decreased or absent reflexes because this could

indicate Magnesium Sulfate Toxicity

Evaluate blood pressure for hypertension: monitored at every prenatal visit

and educate mother to monitor at home.

- Remember hypertension criteria: >140/90 two separate times at least

4 or 6 hours apart.

Edema monitoring (watch for and educate mother about this):

- Weight gain of 2 lbs or more in a week and weigh self daily

- Edema can be in the face, eyes, and extremity swelling

- Monitor urinary output

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