A Clinical Case Analysis Committee of the

College of Nursing and School of Midwifery

City University of Pasay

Pasadeña St. F.B Harrison Pasay City

In partial fulfillment of the requirements in

NCM 109 Related Learning Experience in

PRE-ECLAMPSIA
By:

SHERYL A. DAITOL

ADRIANNE HOWELL ESPINOSA

SICHEM D. EVORA

MARIA JAYZEN F. GUNRAN

PRECIOUS R. HERNANDEZ

CLARISSA JUVIDA

Submitted to:

ARCELLI FRANCISCO RND, RN, MAN

LEONILA PADILLA BAQUIANO RN, MAEd

APRIL 3, 2022

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 i. Introduction:
Pre-eclampsia is a form of high blood pressure in pregnancy.
1 in every 12 to 17 pregnancies among woman ages 20 to 44 have high blood pressure during pregnancy. It
occurs about 6 percent of pregnancies.

Pre-eclampsia happens when the patient is overweight or obese, not getting enough physical activity,
smoking, drinking alcohol, a family history of pregnancy related to hypertension and first-time pregnancy. This
is very risky for the mother and the baby during pregnancy because it can also cause problems during and
after delivery. The effects of it can put the mother and her baby at risk for complications like, eclampsia,
stroke, need for labor induction, premature delivery, and low birth weight for the baby.

The most important thing to do is to talk with your physician or health care provider about any blood pressure
problems so that you can get right treatment and also to control your blood pressure before getting pregnant.
Getting treatment for high blood pressure is so important before, during and after pregnancy to prevent
complications.

For this case analysis, the patient, a 28 years old female, born on February 14, 1993, residing in Pasay City, who was suffering from gestational
hypertension.

ii. Objectives:

GENERAL OBJECTIVES
The objectives of this study are to obtain knowledge about Mother and Child Care with
Abnormalities by presenting this study with sufficient information to serve as a guide for student
nurses. This study also serves as a promotion to healthcare of the patient and to enhance the skills
in the nursing process and management.

SPECIFIC OBJECTIVES
At the end of this study, the group will be able to:

COGNITIVE

1.Recognize the effect of the drugs administered on the patient,

2.Interpret the collected data from the patient and patient's medical record, an
3.Formulate effective nursing care plan

PSYCHOMOTOR
1. Gather reliable information about the patient’s condition through a thorough interview,
2. Provide curative intervention through health teachings,
3. Conduct an assessment about hypertension, and
4. Properly perform nursing interventions.

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ATTITUDE
1. Establish excellent communication skills to easily build rapport with the patient and with patient’s
family members, and
2. Be respectful to people and rules such as keeping their confidentiality and acknowledge their beliefs
and culture.

iii. Limitations:
This case study mainly focuses on the health-related problem and risks associated with
hypertension in pregnancy.

I. Personal Data

NAME: C.V.P
ADDRESS: Pasay City
AGE: 28 years old
SEX: Female
CIVIL STATUS: Single
RELIGION: Roman Catholic
BIRTHDAY: March 5, 1993
BIRTHPLACE: Cavite
ATTENDING PHYSICIAN: Dr. Irene Mutas
CHIEF OF COMPLAINT: Dizziness and Fatigue
DIAGNOSIS: Pre-eclampsia
FHT FUNDIC HEIGHT: 25 cm
WEIGHT: 68 kg

II. Medical History

A. History of Present Illness:

The patient is on her 2nd trimester with a gestational age of 20 weeks when she experienced an off
and on dizziness for at least 1-2 hours accompanied with a slight shortness of breath. Her partner
accompanied her in Dr. Reyes Medical Clinic and had a check-up at January 4, 2022. The patient
diagnoses pre-eclampsia. The physician prescribed a losartan usually it take 1 tablet per day everyday
but she sometimes bypass to drink her prescribed medicine.

B. Past Medical History:

In 2018, the patient diagnoses with pre-eclampsia.

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 C. Family Medical History:
As per the mother’s statement, There’s an associated factor on the side of the mother of this patient.

GRANDMOTHER GRANDFATHER GRANDMOTHER

SISTER MS.C

LEGEND:

GRANDFATHER GRANDMOTHER FATHER MOTHER

SISTER MS.C

HEART FAILURE DIABETIC PRE-ECLAMPSIA

D. Social History:
The patient is the youngest among her siblings. The patient usually spends her time managing her
online business and her house and child. Her daily activities usually begin with some light exercise,
cleaning, cooking, taking care of her children and browsing her phone for orders. She usually eats at
least 4-5 times a day, bathing 2-3 times a day and sometimes hanging out with her friends on some
occasions. Her sleeping pattern, usually she sleeps 8-9 hours and rest or nap in the afternoon for at
least 2-3 hours a day.
The patient has a partner who is hardworking and a caring father with their child. The patient lives with
her partner in their own house.

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 E. Environmental History:
a. The patient lives and own their house, it is well ventilated place with 5 windows (2 in the living
room, 1 on each bedroom and 1 in the back or kitchen) and has 3 doors and a gate. It is made a
concrete, has their own bathroom, Nawasa is their source of water and Mineral water as for
their drinking. Meralco is their source of electricity. They have a motorcycle as a transportation
especially to her husband who is working. Their house is near the hospital, malls, groceries,
school, pharmacy, wet market and public transportation and have a daily garbage collector.
Their source of income is from her husband’s salary and her online business.

F. OB HISTORY
G T P A L M
1 1 0 0 1 0

i. The patients OB score is G1P0 1-0-0-1-0

ii. On 2015, she had a full-term normal pregnancy and delivered a baby boy by
Spontaneous Vaginal Delivery (SVD) at a lying-In Clinic in Cavite and the weight of the
baby was 2.6kg and is alive and well.

G. Gynecology History
Menarche :12 years old

Interval: Regular menstruation

Duration: 6-7
Amount: Normal range,2 -3 moderately soaked pads
Sign and symptoms: Mood swings
Coitarche: Age 18
No. of sexual partner -1

Patient and partner have no sign and symptoms of STD

H. Immunization History (for Pedia Client):

Hepa B vaccine
Tetanus Toxoid
 Dengue
Vaccine

 Hepa B vaccine
 Tetanus Toxoid – first dosage last February 3, 2022 (booster)

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  Dengue Vaccine
 Flu Vaccine
 HPV Vaccine
 Covid Vaccine: 2doses of Sinovac

H. Developmental History:

STAGES NORMAL ACTUAL ANALYSIS/

INTERPRETATI
ON
Abraham Physiological Ms. C is living The biological
Maslow’s needs. with her parents needs of human
Hierarchy of These are and siblings. survival and
Needs biological Their source of secondary need are
requirements for finance is her met.
human survival, husband’s income
e.g. air, food, and her income in
drink, shelter, online business.
clothing, warmth,
sex, sleep. She states that she
If these needs are eats a meal 3
not satisfied the times a day
human body (breakfast, lunch,
cannot function dinner) and
optimally. snacks 4 to 5
Maslow times a day
considered
physiological
needs the most
important as all
the other needs
become
secondary until
these needs are
met.

Safety and Ms. C lives in a The needs of the

security community patient for the
Once an around the area of safety and security
individual’s barangay 91 in are fulfilled and
physiological Pasay City. The satisfied.
needs are community has
satisfied, the barangay and
needs for security police roving
and safety every day and she
become salient. lives near the

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 People want to necessary
experience order, establishment
predictability and (like pharmacy,
control in their hospital, malls,
lives. These needs school, etc.) and
can be fulfilled by emergency
the family and services (like
society (e.g. police station, fire
police, schools, station, etc.)
business and
medical care).

Love and Ms. C had Stated The needs of the

belongingness that she is in an patient for her
needs intimate interpersonal
After relationship with relationships are
physiological and her partner and a satisfied.
safety needs have good relationship
been fulfilled, the with her family
third level of (parents, siblings,
human needs is children),
social and friends/peers and
involves feelings neighbors.
of belongingness.
The need for
interpersonal
relationships
motivates
behavior
Examples include
friendship,
intimacy, trust,
and acceptance,
receiving and
giving affection
and love.
Affiliating, being
part of a group
(family, friends,
work)

Esteem needs Ms. C stated that The patients need

Which Maslow she feels of confidence and
classified into two comfortable dignity, respect
categories: (i) around others and and reputation are
esteem for oneself has a sense of acquired and
(dignity, dignity and satisfied.
achievement, confidence in
mastery, and herself.
independence)
and (ii) the desire
for reputation or
respect from
others (e.g.,
status, prestige).
Maslow indicated

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 that the need for
respect or
reputation is most
important for
children and
adolescents and
precedes real self-
esteem or dignity.

Self-
actualization Ms. C believe that The needs of the
needs she already has a patient were still
Realizing self- fulfillment on process as she
personal potential, and personal still has plans for
self-fulfillment, growth in life the future, but her
seeking personal as for her present
growth and peak Her goal in life is desire and
experiences. A to have a whole fulfillment in life
desire “to become and healthy life she stated that she
everything one is for herself and her is satisfied for
capable of loved ones. now.
becoming”

Erik Erickson’s During this Ms. C’s first The patient is still
Intimacy vs. period, we begin relationship was committed and
Isolation to share ourselves at the age of 15, intimate with her
more intimately their relationship partner for 9 years
with others. We lasted for about 1 and has a happy
explore year during high- relationship with
relationships school. Her 2nd her child, family
leading toward relationship was and friends.
longer-term when she was 18
commitments years old that
with someone lasted for only a 1
other than a year and then to
family member. her 3rdrelationship
Successful (which is her
completion of this current partner)
stage can result in which is when she
happy was 20 or 21
relationships and years old.
a sense of
commitment, Ms. C’s still in a
safety, and care 9- year strong
within a relationship with
relationship her husband and a
Avoiding happy
intimacy, fearing relationship with
commitment and her family and
relationships can friends.
lead to isolation,
loneliness, and
sometimes
depression.
Success in this
stage will lead to

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 the virtue of love.

Freud’s Genital Ms. C’s age

Stage For Freud, the during her first Before pregnancy,
proper outlet of coitarche was 15 the patient and her
the sexual instinct years old husband are still
in adults was heterosexual
through Ms. C is still partner until her
heterosexual sexually active 2nd pregnancy.
intercourse. with her current
Fixation and partner but with
conflict may family planning.
prevent this with
the consequence Ms. C is a
that sexual heterosexual
perversions may
develop.

III. Patterns of Functioning – Altered System

PATTERN OF BEFORE DURING ANALYSIS/

FUNCTIONING PREGNANCY PREGNANCY INTERPRETATION
Health The patient She constantly No changes in
Perception- was concerned followed her health perception-
Health about her health health
Management health due to management management.
Pattern her high blood during her
pressure, she second
followed a pregnancy
good diet, checkups, but
exercise she stopped
regularly, and drinking her
took medicine prescription out
to stay fit and of fear that it
healthy. She is would harm the
very conscious baby (self-

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 of her weight declaration).
and She never
appearance, forgets about
and she herself,
ensures that particularly her
she is attractive appearance
to others.
Nutritional- Since the The patient After the patient
Metabolic Patient was tried to eat became
experiencing carefully during hypertensive she
Hypertension her pregnancy, managed her diet
symptoms, she Ms.C Eat foods due to fear of
focused on her that rich in affecting her high
nutritional Calcium and blood pressure,
requirements, high in vitamin C but due to her
avoiding fatty, and E, 6-11 current
processed servings of pregnancy the
foods and Grains and patient became
carbonated Starches more discipline
beverages. She (1 slice bread; on what to eat
was afraid it 1/2 cup especially when
might get cooked brown she is craving for
worse, so she rice, food.
decided to do oatmeal)
something drinking
about it. between 6 and
She tried to eat 8 glasses of
carefully during water every day.
her pregnancy, she was very
and she was disciplined and
very disciplined limited when
and limited she had desires.
when she had
desires.
Elimination The patient Eliminate only No changes in
usually once a day and elimination
eliminates once urinate for at pattern.
a day (morning) least 5-6 times a
but sometimes day.
every 2 days
and she pee at
least 5-6 times
a day

Activity-Exercise The patient During her No changes in

Pattern always does a pregnancy the Activity-Exercise
light exercise in patient only do Pattern
the morning a light walking
like walking/ and doing
jogging household
sometimes chores as her
dancing or exercise.
doing exercise

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 at home to
keep herself in
check.
Cognitive- The patient is The patient is No changes in
Perceptual oriented to aware of the Cognitive-
pattern what she is time, location, Perceptual
doing because and person, and pattern
of the time, she responds
place, and appropriately to
person. the inquiries.
The client is
aware of the
time, location,
and person,
and she
responds
appropriately
to the inquiries.
Sleep-Rest Depending on During her The patients
Pattern her work and pregnancy she sleep rest pattern
responsibilities, became sleepier changed during
the patient has and lazier as the her pregnancy.
a different days go by. She
sleeping usually naps
pattern each more in the
day. She sleeps afternoon then
at least three she usually
to four times a sleeps between
day, from 11 9pm – 11pm.
p.m. to 1 a.m..
Self-Perception The patient The patient The patient
–Self- seems to be verbalized that seems to be
Conception productive and sometimes she productive and
pattern focused of is not happy focused on
herself. She about herself herself, but
knows what because during because she is
she wants and her pregnancy pregnant now
what she wants sometimes there’s a lot of
to achieve and there is a limitations on
do to her life. limitation in what she can do.
And she seems what I Want and
to be confident what I Want to
about herself do to myself.
Role- The patient is a The Patient is a No changes in
Relationship mother of one mother with a Role-Relationship
Pattern child and a two Child and a Pattern
devoted wife to loving Wife to
her partner. her partner.
Sexuality- The patient is The Mother is The patient is still
Reproductive content and Pregnant and intimate during
Pattern continues to having a child in and before
have a close her womb and pregnancy.
relationship there’s still an

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 with her intimate
husband. They relationship but
continue to no sexual
engage in Activity.
sexual activity,
but with the
use of
contraception
to avoid
unplanned
situations.
Coping-Stress When the When the With the help of
Tolerance patient is patient feels her family and
Pattern stressed she stressed she friends, the
prefers to talk, only consult and patient can cope
drink, and talk to her with or relieve
socialize with partner and stress.
her family and family about it.
friends.. Sometimes she
will be
engrossed
herself in her
online business,
or just relaxing
watching
Korean drama
or Netflix.
Value- Belief The Patient The patient is No changes in
Pattern belief in life is still praying for value and belief
that her family her family to be pattern.
is the top whole and
priority for healthy during
everything… this pandemic.
she always
prays for their
good health

IV. Physical Examination / Review of System

BODY PARTS NORMAL ACTUAL ANALYSIS/

FINDINGS FINDINGS INTERPRETAT

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 ION
Patient is well Normal Findings
GENERAL groomed -well groomed
APPEARANCE Patient behave -Patient behave
AND according to according to her
BEHAVIOR her age age
Appearance
and behavior
are appropriate
- Generally, Normal Findings
uniform in
color
Generally,
except in
uniform in
areas
color except in
exposed to
the areas
the sun.
exposed to the
- No mass,
sun. Skin is
area of
SKIN intact, when
tenderness
pinched it
- Warm to
springs back to
touch
its previous
- When
state
pinched it
immediately.
springs
Warm to touch
back to its
previous
state
HAIR hair is black,
evenly -hair is brown and There is a
distributed, blonde (due to presence of flakes
shiny, lustrous hair dye) on her hair.
and no split -evenly distributed
ends and -shiny
dandruff. No -has presence of
areas of flakes/dandruff
tenderness -no areas of
tenderness
FACE Oval shape, -oval shape Normal Findings
free from -free from
wrinkles, no wrinkles
area of - no area of
tenderness or tenderness or
masses masses

EYES Black or -black in color Normal Findings

brown in color, -symmetrical in
symmetrical in shape and
shape and size, movements, non-
non- protruding
protruding, no -no redness

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 redness Eye grade: 20/20

Eye grade:
20/20

EYEBROWS Black, Black, Normal Findings

symmetrical, symmetrical,
thick, can raise thick, can raise
and lower and lower
eyebrows eyebrows without
without difficulty, Parallel
difficulty, and evenly
Parallel and distributed
evenly
distributed
EYELASHES Black, evenly Black, evenly Normal Findings
distributed and distributed and
parallel to each parallel to each
other other
EARS Parallel, -parallel Normal Findings
symmetrical, -symmetrical
proportional to -proportional to
the size of the the size of the
head head
NOSE Mid line, -mid line Normal Findings
symmetrical -symmetrical and
and patent patent
LIPS Inspection: -thin Normal Findings
thin, pinkish - pinkish
TEETH Inspection: (-) -plaque Normal Findings
plaque, carries -no dentures
dentures
GUMS Pinkish and Pinkish and moist Normal Findings
moist no no swelling or
swelling or lesions
lesions
TONGUE Inspection: -symmetrical Normal Findings
symmetrical, -slightly reddish
slightly and moist
reddish and
moist
VOICE No hoarseness -no hoarseness Normal Findings
and well – and well-
modulated modulated

Inspection: -proportional to
NECK proportional to the size of the Normal Findings
the size of the body and straight.
body and - no palpable
straight. lumps, masses, or
Palpation: no areas of
palpable tenderness
lumps, masses,

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 or areas of
tenderness
CHEST: The skin is -the skin is brown,
GENERAL brown, with with moles, no The patient has a
APPEARANCE moles, no scars scars and lesions presence of tattoo
and lesions. - presence of on her left
tattoo clavicle

POSTURE AND Symmetrical. -symmetrical Normal Findings

SHAPE OF
THE THORAX
SYMMETRY Symmetrical. -symmetrical Normal Findings
OF THE
CLAVICLE
RIB Symmetrical. -symmetrical Normal Findings
SYMMETRY
AND
MOVEMENT
TEMPERATUR Warm to -warm to touch Normal Findings
E touch.
AREAS OF There is no -no presence of Normal Findings
MASSES, presence of mass, lumps and
TENDERNESS mass, lumps areas of
AND LUMPS and areas of tenderness.
tenderness.
BREATH No presence of -no presence of Normal Findings
SOUND any crackles, any crackles,
wheezing, or wheezing, or
abnormal abnormal sounds.
sounds.

The breast is -the breast is The nipple of the

BREAST white, round with moles. patient is
with/without darkening due to
moles. pregnancy

Symmetrical in Symmetrical in Normal Findings

size and shape size

Skin or nipple Nipple is everted

change and dark in color
because of her
No scars or pregnancy.

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 lesions.
No scars or
No mass, lesions.
lesions, lumps
and area of
tenderness
HEART Auscultation: -no presence of Normal Findings
No presence of any adventitious
any sound.
adventitious
sound. - no murmur

ARM Warm and Warm to touch, no The patient has a

smooth, no bruise or lesion presence of tattoo
presence of but there is a on her left arm
mass, lesions presence of tattoo,
and area of no area of
tenderness. tenderness and
Warm to touch masses.
UMBILICAL Concave -concave Normal Findings

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V. Anatomy & Physiology:

Hypertension occurs when the body’s smaller blood vessels (the arterioles) narrow, causing the blood to exert
excessive pressure against the vessel walls and forcing the heart to work harder to maintain the pressure.
Although the heart and blood vessels can tolerate increased blood pressure for months and even years,
eventually the heart may enlarge (a condition called hypertrophy) and be weakened to the point of failure.
Injury to blood vessels in the kidneys, brain, and eyes also may occur.
Blood pressure is actually a measure of two pressures, which is the systolic and the diastolic. The systolic
pressure (the higher pressure and the first number recorded) is the force that blood exerts on the artery walls
as the heart contracts to pump the blood to the peripheral organs and tissues while diastolic pressure (the
lower pressure and the second number recorded) is residual pressure exerted on the arteries as the heart
relaxes between beats. A diagnosis of hypertension is made when blood pressure reaches or exceeds 140/90
mmHg and can be read as “140 over 90 millimetres of mercury”.

PATHOPHYSIOLOGY

PRE-ECLAMPSIA

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 Preeclampsia is a disorder of widespread vascular endothelial
malfunction and vasospasm that occurs after 20 weeks' gestation
and can present as late as 4-6 weeks post-partum. It is clinically
defined by hypertension and proteinuria, with or without pathologic
edema.
 Hypertension is one of the common medical disorders in pregnancy,
and a leading cause of maternal and perinatal mortality.
 This issue often starts in the second half of pregnancy. It normally goes
away after your baby is born.

Signs/Symptoms

• Blood pressure higher than 140/90 mmHg.

• Pain around your stomach.

DIAGNOSIS
•Diabetes
Blood pressure
readings • Edema

Laboratory results
Treatment

• Continued laboratory testing of urine and

blood (for changes that may signal worsening
of PIH).

• Bedrest (either at home or in the hospital

may be recommended).

•Hospitalization (as specialized personnel

and equipment may be necessary).

Hypertension is defined as blood pressure greater than or equal to 140/90 mm Hg. The condition is
a serious concern for some pregnant women. There are several possible causes of high blood
pressure during pregnancy like being overweight or obese, not getting enough physical activity,
smoking or drinking alcohol, a family history of pregnancy-related hypertension, having diabetes or
certain autoimmune diseases. It is thought to be related to a mechanism of reduced placental
perfusion inducing systemic vascular endothelial dysfunction. This arises due to a less effective

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 cytotrophoblastic invasion of the uterine spiral arteries. The resultant placental hypoxia induces a
cascade of inflammatory events, disrupting the balance of angiogenic factors, and inducing platelet
aggregation, all of which result in endothelial dysfunction manifested clinically as the preeclampsia
syndrome. Angiogenic imbalances associated with the development of preeclampsia include
decreased concentrations of angiogenic factors such as the vascular endothelial growth factor
(VEGF) and placental growth factor (PIGF) and increased concentration of their antagonist, the
placental soluble fms-like tyrosine kinase 1 (sFlt-1).

VII. Laboratory and Diagnostic Examination – Recent to past

LABORATORY AND DIAGNOSTIC EXAMINATION

DATE: 04 APRIL 2022

RADIOLOGY REPORT
PELVIC ULTRASOUND
ULTRASOUND FINDINGS:
Fetal number Single
Fetal Presentation Cephalic
Placental Location, grade Left posterolateral, high grade II
Amniotic Fluid Adequate
Fetal movement Active
Cardiac activity 153 bpm
Sex Female

IMPRESSION:
Single, live intrauterine pregnancy in cephalic presentation about 35 weeks 4 days age of gestation
based on BPD, FL and AC.
Normal placental localization and amniotic fluid volume.

DATE: 04 JANUARY 2022

OBSTETRICAL ULTRASOUND
ULTRASOUND FININGS:
Fetal Number – Single

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 Fetal Presentation - complete breech
Placenta – posterior grade II, 2.5 cm from internal os
Amniotic fluid volume – adequate AFI = 11.0 (3.7, 2.0, 3.6, 1.7)
Heart rate – 157 bpm
Gender – Female

IMPRESSION:
Single live intrauterine fetus, complete breech, compatible to 20 weeks 6 days gestation by fetal
biometry (sonar gestation)
Low lying placenta
Right ovary – unremarkable
Left ovary – not visualized

DATE: 29 December 2021

Laboratory Result Normal Analysis/

Examination Values Interpretation
Urinalysis
Pus Cells 0-3 (0-5 per high Normal
power field)

Color Yellow
Appearance/ Slightly Turbid
Transparency
PH Normal 6.5
SP. GR Normal 1.005
Protein Normal
Sugar Normal Negative
Appearance/ Slightly Turbid
Transparency

DATE: 29 December 2021

HEMATOLOGY

NORMAL ACTUAL ANALYSIS/

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 FINDINGS FINDINGS INTERPRETATI
ON
Hemoglobin F: 11.0 – 15.0 17.6 High
gms Hemoglobin
Level
Hematocrit F: 37-47 vol% 36 Low Hematocrit
Level (indicates
more red blood
cells)
White Blood 5,000 – 10,000 / 11,000 High White
Cell cu.mm Blood Cell
(Leukocyte) (indicate
infection/
inflammation)
Platelet 150,000 – Adequate Adequate
400,000 / cu.mm
Blood / RH A (+)
type
Differential Count
Bands / Stab 0–7
Segmenter 50 – 70 66 Normal
Eosinophil 0–5 0-9 High (indicate as
infection/ an
allergic reaction)
Basophil 0–1
Lymphocyte 20 – 40 25 Normal
Monocyte 0–7
Other

I. MEDICAL AND SURGICAL INTERVENTION

N/A

II. DRUG STUDY

Name Classificati Mechanis Indication Contraindic Adverse effect/s Nursing

on m of ation Responsibilities

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 action
Generic Angiotensin Angiotensi Treatment Hypersensiti CNS: Dizziness, Monitor BP at drug
Name: receptor n II of vity to insomnia, trough (prior to a
Losartan blockers receptor hypertensio losartan, headache scheduled dose).
(ARBs), (type n pregnancy GI: Diarrhea,
anti- AT1) [category C dyspepsia Monitor drug
Brand hypertensiv antagonist (first effectiveness, especially
Name: e acts as a trimester), Musculoskeletal: in African-Americans
Cozaar potent category D Muscle cramps, when losartan is used as
vasoconstr (second and myalgia, back or monotherapy.
ictor and third leg pain
Dose:50 Inadequate response
primary trimesters)], Respiratory:
mg /1 tab may be improved by
vasoactive lactation Nasal congestion,
per day, splitting the daily dose
hormone cough, sinusitis
of the into twice-daily dose.
Frequenc
y: renin–
Lab tests: Monitor CBC,
Once a angiotensi
electrolytes, liver &
day n–
kidney function with
aldosteron
long-term therapy.
Route: e system
PO

Name Classification Mechanism Indication Contraindication Adverse Nursing

of action effect/s Responsibilities
Generic Iron An iron Iron Hypersensitivity Constipation Avoid use in
Name: supplement supplement Deficiency peptic ulcer
Ferrous used to Anemia Hemochromatosis, Diarrhea disease,
Sulfate treat or hemolytic anemia ulcerative colitis,
prevent low Dark stools regional enteritis,
Brand blood levels and patients
Name: of iron (e.g., Nausea receiving
Ferrous for anemia frequent blood
Sulfate or during Stomach transfusions.
pregnancy). pain
Iron is an Avoid
Dose: Superficial administering
important
27 mg per tooth iron for more
mineral that
day discoloration than 6 months
the body
(oral except in patients
needs to
Frequency: solutions) with continuous
produce red
Once a day blood cells bleeding or
Urine
and keep menorrhagia.
Route: PO discoloration
you in good
health.
Vomiting

Name Classificatio Mechanis Indication Contraindica Adverse effect/s Nursing Responsibilities

n m of tion

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 action

Generic Vitamin D The active Vitamin D sarcoidosis. Most people do Do not take this drug if
Name: (ergocalcife form supplemen not commonly experiencing of
high amount
Vitamin rol-D2, of vitamin ts are used experience side hypercalcemia and
of phosphate
D cholecalcife D binds to to treat effects with report immediately to
in the blood.
rol-D3, intracellul adults with vitamin D, unless physician.
alfacalcidol) ar severe high amount too much is
Brand is a fat- receptors vitamin D of calcium in taken. Some side
Name: soluble that then deficiency, the blood. effects of taking Consult physician
Vitamin vitamin that function resulting in too much vitamin before taking an OTC
helps your as loss of excessive D
D medication. Calcium,
body transcripti bone amount of include weakness phosphate, or
absorb calci on factors mineral vitamin D in , fatigue, sleepine magnesium-containing
um and to content, the body. ss, headache, loss laxatives and antacids,
phosphorus modulate bone pain, of appetite, dry mineral oil, and vitamin
kidney
Dose: . gene muscle mouth, metallic D preparations may
stones.
4000 expression weakness taste, nausea, vo increase adverse effects
units per . Like the and soft decreased miting, and of calcifediol and
day receptors bones kidney others. therefore should be
for other (osteomala function. avoided.
steroid cia). Osteo
trimesters)], Note: Patients
Frequenc hormones porosis.
lactation undergoing dialysis may
y: Once a and
thyroid require aluminum
day
hormones, carbonate or hydroxide
the vitami gels to bind intestinal
n phosphate and thus
Route:
D receptor lower serum phosphate
PO
has levels.
hormone-
Do not breast feed
binding
while taking this drug.
and DNA-
binding
domains.

Name Classification Mechanism of Indication Contraindication Adverse Nursing

action effect/s Responsibilities

LPB2022
Obimin Vitamin and Obimin A pre-and If the patient is Diarrhea, May be taken
Plus minerals (Calcium postnatal allergic to any constipation with or without
Lactate) supplement component of or upset food
acetate, when to help the product. stomach may
taken with provide occur. This May also be
meals, adequate Hypersensitive effect is taken with meals
combines with supply of to this usually for better
dietary vitamins, medication or temporary absorption or to
phosphate to minerals any of the and may reduce GI
form an and omega- ingredients. disappear as discomfort.
insoluble 3 fatty your body
Obimin acids, DHA adjust this Give the
(Calcium and EPA, medication prescribed drug
Lactate) during to the patient.
phosphate pregnancy .
complex, and Hypercalcemia
which is lactation. is discussed
excreted in elsewhere
the feces,
resulting in
decreased
serum
phosphorus
concentration.

X. Nursing Care Management

B. Nursing Care Plan (NCP)

Note: Minimum of 3 identified problems per classification (actual, potential/risk, wellness)

LPB2022
 ACTUAL NURSING CARE PLAN

ASSESMENT DIAGNOSIS INFERENCE PLANNING INTERVENTION RATIONALES EVALUATION

Subjective: Deficient Knowledge deficit Short term: Short term:
Knowledge is a lack of  Asses the  It will help the
“Ano ba ang related to cognitive after 1-2 hours of patient patient about after 1-2 hours of
mga kailangan Unfamiliarity information or nursing current the presence of nursing
kong gawin para with psychomotor intervention the knowledge hypertension, intervention the
mapababa ang information skills required for patient will be about as well as giving patient is able to
blood pressure resources. health recovery, able to hypertension. insights of the Participate in
ko” as maintenance, or Participate in possible change learning process
verbalized by health learning process in lifestyle. and exhibit
the patient. promotion. and exhibit increased interest
Teaching may increased interest and assume
take place in a and assume  The mentioned responsibility for
Objective: hospital, responsibility for  Teach the risk factors own learning by
 overweight
obese ambulatory care, own learning by patient in were proven to beginning to look
 35 weeks or home setting. beginning to look identifying worsen for information
and 4 days The learner may for information modifiable risk hypertension. and ask questions
pregnant be the patient, a and ask questions factors such as
family member, a obesity, high
 Variations significant other, sodium and Long term:
in blood or a caregiver Long term: fat diet,
pressure. unrelated to the sedentary and After 1-2 days of
patient. Learning After 1-2 days of stressful life nursing
 Dizziness may involve any nursing style, smoking information the
of the three information the and drinking patient verbalized
 Shortness domains: patient will alchohol. understanding
of breath cognitive domain verbalize one's  The patient's about
(intellectual understanding  Instruct the ability to hypertension
Temp: 36.6 C activities, about patient to measure BP at progression and
BP: 140/90 problem solving, hypertension perform home enhances possible
RR: 18 and others); progression and monitoring of one's treatment and
PR: 78 bpm affective domain possible blood awareness to learn to maintain
Weight: 68 kg (feelings, treatment and pressure level hypertension. BP within the
attitudes, learn to maintain at home. acceptable range.
beliefs); and BP within the  Inconsistent
psychomotor acceptable range. and lack of

POTENTIAL NURSING CARE PLAN

LPB2022
 ASSESMENT DIAGNOSIS INTERFERENCE PLANNING INTERVENTION RATIONALES EVALUATION
Subjective: Risk for Decreased  Preeclamps After 8 hours independent: After 8 hours of
'minsan para akong cardiac output ia is a of nursing  Monitor blood  Comparison Nursing
nahihilo o parang related to common interventions, pressure of of Pressures interventions,
parang ngalay yung decreased venous problem the patient will the patient. provides a the patient was
leeg ko, tapos return. during have an Measure in more able to
minsan naman pregnancy. improved both arms or complete participate in
mabilis ako hingalin The cardiac output thighs three picture of activities that
or mapagod” as condition as manifested times, 3- vascular reduce blood
stated by the sometimes -blood pressure 5minutes involvement pressure.
patient. referred to of 120/80 apart while or scope of
as patient is at the problem.
Objective: pregnancy rest, then
induced sitting, then
 obese hypertensi standing for
 overweight
on is initial
 35 weeks defined by evaluation.
and 4 days high blood  Presence of
pregnant pressure  Observe skin pallor, cool,
and excess color, moist skin
 Variations protein in moisture, and delayed
in blood the urine temperature capillary refill
pressure. after 20 and capillary time may be
weeks of refill time. due to
 Dizziness pregnancy. peripheral
Often, vasoconstrict
 Shortness preeclamps ion
of breath ia causes
only  May indicate
Temp: 36.6 C modest  Note heart failure,
BP: 140/90 increases dependent or renal or
RR: 18 in blood general vascular
PR: 78 bpm pressure. edema. impairment.
Weight: 68 kg Left
untreated,  Provide calm,  Help reduce
however, restful Sympathetic

WELLNESS NURSING CARE PLAN

LPB2022
ASSESMENT DIAGNOSIS INFERENCE PLANNING INTERVENTION RATIONALES EVALUATION
Subjective: Readiness for High blood Short term: Encourage client Regular exercise Goal met:
enhanced self pressure (HBP) After 2 hours of to do daily helps keep your The client will be able
“Ano ba ang health or Nursing intervention, exercises like heart and arteries to understand and
mga kailangan management hypertension the walking, jogging healthy, improves apply the ways
kong gawin para related to high means high client will be able to or do aerobic blood flow, and to keep and
mapababa ang blood pressure understand the exercise every reduces stress. manage her
blood pressure pressure. (tension) in ways to keep her blood week. blood pressure
ko” as the arteries. pressure within normal within normal
verbalized by Arteries are range. range.
the patient. vessels that Teach client in to develop better-
carry blood determining coping skills for
from the Long term: stressors which dealing with
Objective: pumping heart After 1 day Of nursing may affect her stressful
 Obese to all the intervention, the client blood pressure. experiences.
 overweight
tissues and will be able to apply
 35 weeks organs of the ways on how to manage
and 4 body. High her Encourage client To help relieve
days blood pressure blood pressure. to follow a some of the
pregnant does not mean heart-healthy symptoms
excessive diet like eating associated with
 Variations emotional more fruits, hypertension.
in blood tension, vegetables,
pressure. although whole grains
emotional and other
 Dizziness tension and high-fiber foods
stress can
 Shortness temporarily
of breath increase blood
pressure.
Temp: 36.6 C Normal blood
BP: 140/90 pressure is
RR: 18 below 120/80;
PR: 78 bpm blood pressure
Weight: 68 kg between
120/80 and

References:

https://www.cdc.gov/bloodpressure/about.htm#:~:text=High%20blood%20pressure%2C%20also
%20called,blood%20pressure%20(or%20hypertension).

https://www.cdc.gov/bloodpressure/pregnancy.htm

https://www.mims.com/philippines/drug/info/obimin

https://www.who.int/health-topics/hypertension/#tab=tab_1

LPB2022