Preeclampsia-Eclampsia
RAPID Reasoning
Dana Myers, 40 years old
Primary Concept
Intracranial Regulation
Interrelated Concepts (In order of emphasis)
1. Perfusion
2. Reproduction
3. Clinical Judgment
© 2016 Keith Rischer/www.KeithRN.com
RAPID Reasoning Case Study: STUDENT
Preeclampsia-Eclampsia
History of Present Problem:
Dana Myers is a 40-year-old woman, G-3 P-2 who is 34 weeks gestation. Her health care provider has been monitoring
her weekly because her blood pressure has been increasing the past month and is currently 146/88. Last week she had 1+
non-pitting edema of both lower extremities (BLE) and her urine was negative for protein. Today during her clinic visit,
Dana’s BP was 168/90. She had 2+ proteinuria and 3+ pitting edema BLE. She also complained of a mild headache in
This study source was downloaded by 100000897367967 from CourseHero.com on 09-15-2025 04:52:33 GMT -05:00
https://www.coursehero.com/file/247093920/Case-Study-Preeclampsia-RAPID-Reasoning-2pdf/
, the center of her forehead, and seeing “spots.” Fetal heart tones via Doppler are 136/minute in the lower left quadrant.
Abdominal measurement from pubic bone to top of fundus is 31 cm.
The primary care provider was concerned and Dana has been admitted to the community hospital labor and delivery
unit to be evaluated for severe preeclampsia. You are the admitting nurse responsible for her care.
Personal/Social History:
Dana has two children, ages two and four. She is married and both she and her husband are excited to have another
baby, but have been concerned about this pregnancy. Dana’s previous two pregnancies were healthy, without incident,
resulting in the vaginal births of a boy, then a girl. Dana’s parents live in the same town and are supportive.
Dana works part-time teaching English at the local community college. Her husband is an engineer who works full
time and is occasionally out of town for work. Dana is generally healthy, without any chronic illnesses. She does not
smoke or use recreational drugs. She reports drinking socially but refrains while pregnant.
What data from the histories are RELEVANT and has clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Increased risk of preeclampsia
Rising blood pressure indicates signs of preeclampsia and raises
the risk of seizures
Impaired kidney function with protein present in urine
Swelling (edema) may suggest fluid retention and impaired
circulation
Persistent headache consistent with hypertensive urgency,
increasing seizure risk
Fetal heart rate abnormalities may indicate fetal asphyxia
Fundal height below expected levels can detect intrauterine growth
restriction
RELEVANT Data from Social History: Clinical Significance:
Previous pregnancy was healthy with low preeclampsia risk
Patient is supported by their partner and excited about the
upcoming baby
Additional support may reduce stress levels
Patient's good health suggests a low risk of preeclampsia
Smoking can lead to fetal asphyxia
Patient Care Begins:
Current VS: P-Q-R-S-T Pain Assessment (5th VS):
T: 98.4 F/36.9 C (oral) Provoking/Palliative: None
P: 84 (regular) Quality: Stabbing/throbbing
R: 20 (regular) Region/Radiation: Eyes, forehead
BP: 164/98 Severity: 5/10
O2 sat: 95% room air Timing: Constant, unrelieved by acetaminophen
This study source was downloaded by 100000897367967 from CourseHero.com on 09-15-2025 04:52:33 GMT -05:00
https://www.coursehero.com/file/247093920/Case-Study-Preeclampsia-RAPID-Reasoning-2pdf/
RAPID Reasoning
Dana Myers, 40 years old
Primary Concept
Intracranial Regulation
Interrelated Concepts (In order of emphasis)
1. Perfusion
2. Reproduction
3. Clinical Judgment
© 2016 Keith Rischer/www.KeithRN.com
RAPID Reasoning Case Study: STUDENT
Preeclampsia-Eclampsia
History of Present Problem:
Dana Myers is a 40-year-old woman, G-3 P-2 who is 34 weeks gestation. Her health care provider has been monitoring
her weekly because her blood pressure has been increasing the past month and is currently 146/88. Last week she had 1+
non-pitting edema of both lower extremities (BLE) and her urine was negative for protein. Today during her clinic visit,
Dana’s BP was 168/90. She had 2+ proteinuria and 3+ pitting edema BLE. She also complained of a mild headache in
This study source was downloaded by 100000897367967 from CourseHero.com on 09-15-2025 04:52:33 GMT -05:00
https://www.coursehero.com/file/247093920/Case-Study-Preeclampsia-RAPID-Reasoning-2pdf/
, the center of her forehead, and seeing “spots.” Fetal heart tones via Doppler are 136/minute in the lower left quadrant.
Abdominal measurement from pubic bone to top of fundus is 31 cm.
The primary care provider was concerned and Dana has been admitted to the community hospital labor and delivery
unit to be evaluated for severe preeclampsia. You are the admitting nurse responsible for her care.
Personal/Social History:
Dana has two children, ages two and four. She is married and both she and her husband are excited to have another
baby, but have been concerned about this pregnancy. Dana’s previous two pregnancies were healthy, without incident,
resulting in the vaginal births of a boy, then a girl. Dana’s parents live in the same town and are supportive.
Dana works part-time teaching English at the local community college. Her husband is an engineer who works full
time and is occasionally out of town for work. Dana is generally healthy, without any chronic illnesses. She does not
smoke or use recreational drugs. She reports drinking socially but refrains while pregnant.
What data from the histories are RELEVANT and has clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Increased risk of preeclampsia
Rising blood pressure indicates signs of preeclampsia and raises
the risk of seizures
Impaired kidney function with protein present in urine
Swelling (edema) may suggest fluid retention and impaired
circulation
Persistent headache consistent with hypertensive urgency,
increasing seizure risk
Fetal heart rate abnormalities may indicate fetal asphyxia
Fundal height below expected levels can detect intrauterine growth
restriction
RELEVANT Data from Social History: Clinical Significance:
Previous pregnancy was healthy with low preeclampsia risk
Patient is supported by their partner and excited about the
upcoming baby
Additional support may reduce stress levels
Patient's good health suggests a low risk of preeclampsia
Smoking can lead to fetal asphyxia
Patient Care Begins:
Current VS: P-Q-R-S-T Pain Assessment (5th VS):
T: 98.4 F/36.9 C (oral) Provoking/Palliative: None
P: 84 (regular) Quality: Stabbing/throbbing
R: 20 (regular) Region/Radiation: Eyes, forehead
BP: 164/98 Severity: 5/10
O2 sat: 95% room air Timing: Constant, unrelieved by acetaminophen
This study source was downloaded by 100000897367967 from CourseHero.com on 09-15-2025 04:52:33 GMT -05:00
https://www.coursehero.com/file/247093920/Case-Study-Preeclampsia-RAPID-Reasoning-2pdf/
