Preeclampsia is a hypertensive disorder; however, the actual cause of the disease is unknown. Because this condition begins at conception, it is believed that the placenta plays an important role in causing preeclampsia. In women without preeclampsia, the spiral arteries in the placenta remodel to allow sufficient oxygen and blood flow to the fetus. In preeclamptic women, the remodeling of the spiral arteries does not take place, resulting in narrow vessels and hypoperfusion. This, combined with placental infarction, can lead to placental hypoxia.
As this condition progresses, numerous maternal complications occur at the same time depending upon the “extent of the inflammatory process and the maternal response to those inflammatory signals” (Townsend & Drummond, 2011, p. 246). This “hyperinflammatory” state leads to endothelial damage which then leads to a decrease in colloid oncotic pressure. Other factors playing a part in preeclampsia are elevated fibronectin levels and circulating levels of soluble endoglin.
Preeclampsia is also associated with vasospasms, abnormal homeostasis, and activation of the coagulation system. Upon endothelium being damaged, clots begin to form causing vasoconstriction. This leads to a hyperdynamic state in which blood pressure is increased and there is low vascular resistance.
It is believed that maternal and fetal genes have an impact in the process of this disease. Researchers are now studying...
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...king the time to perform accurate thorough head to toe assessment.
In the future, I think nurses, especially those who work in an OB setting, should be required to take a continuing education class on preeclampsia. Nurses need to also be able to accurately read a fetal monitor strip and understand the medications used to treat this disease. The research and implications for care is constantly changing, and it is of the utmost importance for nurses to have a broad understanding of this disease in order to provide the best possible care.
Townsend, N., & Drummond, S. (2011). Preeclampsia: Pathophysiology and implications for care. Journal of Perinatal & Neonatal Nursing, 25(3), 245-252. Retrieved February 20, 2011 from http://cgez.waynecc.edu:2141/sp-3.5.1a/ovidweb.cgi?&S=
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