This is an intervention by the midwife to a pregnant woman/client with mild with high blood pressure and protein in urine.
Aims
· Prevent client from having eclampsia
· Prevent foetal compromise and death
· Prevent other maternal morbidities and complications
Requirements
· Vital signs tray
· Delivery tray
· Induction tray
· Oxytocin
· Intravenous line tray
· Foetal monitor (manual /electronic)
· Oxygen Apparatus
· Perineal Pad
· Patella Hammer
· Urine Dipsticks
· Blood and Urine sample bottles
· Maternal and Child Health Record Book (Manual/Electronic)
Steps
1. Establish rapport (refer steps)
2. Explain procedure to client (refer steps)
3. Explain to client the need to attend antenatal clinic and procedures involved
4. Perform a rapid evaluation of the general condition of the woman, including vital signs
5. Take history of the present and past illness from her relatives
6. Ascertain gestational age to help in proper diagnosing of pre-eclampsia
7. Maintain Infection Prevention and Control measures throughout management
8. Perform general examination from head to toe
9. Obtain urine sample and test for protein and sugar
10. Take blood sample for BUE & Creatinine, FBC, Rh status, grouping and cross matching etc.
11. Monitor vital signs and foetal heart rate every 4 hourly and record
12. Teach mother to record foetal kick count
13. Serve client with normal diet low in salt, fats and oils but more roughage and fluids
14. Educate and encourage client to avoid caffeinated drinks and over the counter drugs
15. Administer prescribed medication
16. Provide conducive environment to promote rest and sleep
17. Assess client for blurred vision, epigastric pain, severe frontal headache and report immediately when noticed
18. Monitor urine protein daily
19. Monitor patient weight daily for sudden weight gain
20. Discharge client when condition remains stable and gestation age is less than 37 weeks
21. Encourage client to report twice weekly to monitor blood pressure, proteinuria, reflexes and foetal well-being
22. Keep the client in hospital for continuous management if the signs remain unchanged
23. Monitor client and foetal growth closely by measuring the symphysio-fundal height and foetal heart sounds
24. Prepare for early delivery when there is evidence of growth restriction or worsening of maternal condition irrespective of gestational age
25. Follow the management of severe pre-eclampsia if there is increasing urinary protein levels
26. Communicate findings to client and family
27. Record and report all information in the Maternal and Child Health Book (Manual or Electronic)
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