Care for an African American antenatal client with acute renal failure


 


Definition: Antenatal care refers to care being given to the pregnant mother before birth. Antenatal care aims to monitor and promote the wellbeing of a mother and her developing baby. It includes the routine examination of the pregnant woman by an obstetrician, nurse practitioner, or certified nurse-midwife. Health promotion interventions are important during the antenatal period and can improve well-being of the woman and the fetus.


 


Assessment:


Subjective: In the antenatal care of an African American pregnant woman, the nurses noticed that the woman had hemorrhage. Objective: Tests show inadequate renal perfusion due to fluid and electrolyte depletion or to hemorrhage.


 


Nursing diagnosis:


Nursing diagnosis shows that the pregnant patient has acute renal failure. It is a clinical condition associated with rapid, steadily increasing azotemia, with or without oliguria. The causes of this are diverse and is still not clear in the case of the pregnant patient.


 


 


 


Implementation:


All the possible consequences associated with each possible nursing action shall be considered in the implementation of the care for the client. The client may then need to adhere to the treatment modalities that are prescribed to her. Not only the pregnant patient should know about these, but the fami8ly of the pregnant patient should also be aware of this.


 


Evaluation: initial evaluation should seek reversible or specifically treatable causes of acute renal failure. Bladder neck obstruction is probably the most common cause of sudden, and often total, cessation of urinary output. The pregnant woman has a succeeding history of difficulty in voiding.


 


Clinical manifestations: The first sign of pregnancy is absence of an expected menstrual period. At this time, the pregnant woman may also notice breast engorgement with nausea and occasional vomiting. The breast engorgement is caused by increased levels of estrogen and progesterone. The urinary sediment is usually unremarkable but may contain white and red cells as well as casts.


 


Diagnostic studies: Pelvic examination at this time shows uterine enlargement compatible with pregnancy, and a slide agglutination test for urinary HSG usually will be positive. Other signs seen on diagnostic studies at this time are helpful. Three important signs of pregnancy are fetal heart tones, fetal movements, and identification of a fetal skeleton. 


References


 


 



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