I am not an OB nurse. In fact I work in ED. That having been said.....Had an experience last night that made me feel really terrific...I was triaging a 28.5 week pregnant 29 y/o w c/o sinus headache. Pt denied OB problems.
Stated she just had a terrible headache. BP 191/108 HR 75. At first I thought it was because her head was hurting so badly. I was almost through w triage when pt said she had test ran that day for "edema". I said edema? She stated yes, but I haven't heard anything about the results. BIG RED LIGHT!!! I immediately stopped what i was doing and reported to the physician, and was told to take pt up to OB. Pt was admitted to OB. Mag was started in OB and HA immediately ceased. Within 1 1/2 hours of coming to ED, pt was transported to another facility for delivery. She was pre-eclamptic (sp?).
I am sorry for the patient, but I feel good that I had a small role in getting her seen about so quickly.
.......Sorry just wanted a pat on the back.......:) :balloons:
I'm a student going in to my preceptorship, so one question. The BP of 191/108 was something you routinely see with a headache and it didn't raise any red flags by itself?
Seems like something worth investigating, especially in a pregnant patient.
I'm not a nurse yet, but when I read the posted BP I knew there was something wrong. But, she did a good job. She alerted the people who needed to be alerted and she did was she was supposed to. Give her some props!
I'm a student going in to my preceptorship, so one question. The BP of 191/108 was something you routinely see with a headache and it didn't raise any red flags by itself?
Seems like something worth investigating, especially in a pregnant patient.
We don't usually see pregnant pts w/ bp's this high. We, as general rule, automatically, take any pregnant pt over 20 week gestation, to the OB dept. Unless, of course, the pt presents to the ER w/ a non-pregnancy c/o, as the pt mentioned above. She came to the ER to be treated for a sinus headache, not OB related complaint.
A BP of 191/108 is high in anyone, but we see a lot of people in our ER with high BP. Had a pt the other night with a BP of 210/130 and no headache. As we all know, pain will increase BP. As I said, at first, I thought the high BP was because of the bad headache. Pt had no noticable edema, or other pre-eclampsia symptoms at that time. She did, however, vomit 3 times, AFTER, she was placed in a wheel chair for transport to the OB dept.
What an excellent piece of work. Pre-eclampsia is more commonly found from 32 weeks onwards, and not being an OB specialist, as you say, the hypertension she had could have been there pre-pregnancy, so adding up the raised BP, edema (or oedema as spelt in the UK) and headache was a good call. You have saved a whole family from potential emotional trauma - pre-eclampsia is still one of the major causes of fetal and maternal death - kudos to you.
We don't usually see pregnant pts w/ bp's this high. We, as general rule, automatically, take any pregnant pt over 20 week gestation, to the OB dept. Unless, of course, the pt presents to the ER w/ a non-pregnancy c/o, as the pt mentioned above. She came to the ER to be treated for a sinus headache, not OB related complaint.
A BP of 191/108 is high in anyone, but we see a lot of people in our ER with high BP. Had a pt the other night with a BP of 210/130 and no headache. As we all know, pain will increase BP. As I said, at first, I thought the high BP was because of the bad headache. Pt had no noticable edema, or other pre-eclampsia symptoms at that time. She did, however, vomit 3 times, AFTER, she was placed in a wheel chair for transport to the OB dept.
Penny, you did well. You knew something was amiss and you took action.
Don't feel like you have to explain anything.
Some people just like to poo-poo and knit-pick....:)
For the students who asked about the b/p. Yes, that is a dangerous blood pressure that could have led to a stroke. Anyone with a systolic above 200 or a diastolic above 100 needs a medical intervention. Luckily this woman went to the ER , and luckily penny picked up on it and acted on it fast.
Penny, you did well. You knew something was amiss and you took action.
Don't feel like you have to explain anything.
Some people just like to poo-poo and knit-pick....:)
I'm a student asking a relevant question in order to sharpen my diagnostic skills and develop my ability to "connect the dots" with all the assessment data.
I have had enough experience over the last couple of semesters to know that often there is a huge difference between what the books say and what happens in real life, and I was asking for clarification. If that falls under the category of "poo-poo" and "knit-pick" to you, I sincerely hope you're not going to be one of my preceptors this semester.
Thank you, Penny and steelcityrn, for the explanation.
:yeah:
txdude35
50 Posts
Nice catch.
I'm a student going in to my preceptorship, so one question. The BP of 191/108 was something you routinely see with a headache and it didn't raise any red flags by itself?
Seems like something worth investigating, especially in a pregnant patient.