Toxemia Research Paper

Toxemia: A Systemic Effect on Pregnancy
Toxemia is a medical term that is being used less and less today. Preeclampsia is now the preferred term used by medical professions, to classify a group of symptoms that can occur during pregnancy and postpartum. The severity of the disorder is often misunderstood. In the next few pages, preeclampsia; also known as toxemia, will be discussed and explained in its entirety. The focus will be on the pathophysiology, nursing management, and community resources for those dealing with this disorder. There will also be three articles discussed and summarized. They are as follows; A Historical Overview of Preeclampsia by Mandy J. Bell, The New Hypertensive Guidelines for Pregnancy by Nicole Franzen Pfaff, CNM,
MSN, and Effect of an Educational Intervention on Cardiovascular Disease Risk Perception among Women with Preeclampsia by Patsy M. Spratling, Erica R. Pryor, Linda D. Moneyham, Ashley L. Hodges, Connie L. White-Williams, and James N. Martin, Jr..
Pathophysiology
Preeclampsia is seen in 3-14 percent of pregnancies worldwide (Michele Davidson, 2011).
It is considered the disease of first pregnancies (III, 2004). Most hear preeclampsia and think of elevated blood pressure during pregnancy. This is a major symptom of preeclampsia, but research and more knowledge of this disorder is showing that preeclampsia is affecting many parts of the body and causing a systemic shift in pregnant women. There are many theories on the pathophysiology behind this complex syndrome, but the true cause still seems to be unknown. Research has shown that preeclampsia is the number one cause of maternal mortality, so it is of great importance that research for the primary cause of this syndrome continues (SeonAe Yeo,
2010). Preeclampsia is classified as a syndrome that affects the mother and fetus. Classic clinical symptoms include the sudden onset of elevated blood pressure and extensive protein in urine; typically seen after 20 weeks of gestation, and up to six weeks postpartum (Foundation, 2000). Preeclampsia has a profound impact on many systems within the pregnant body. The major systems affected are cardiovascular, pulmonary, and the renal system (Michele Davidson, 2011). These are the most vital systems in the body, which shows how dangerous this disorder can be. Preeclampsia results in decreased profusion to many major organs, and if uncontrolled may lead to seizures. Important symptoms that indicate preeclampsia are headaches, shortness of breath, edema, abdomen pain, confusion, nausea and vomiting, blurred vision, and anxiety (Foundation, 2000). Many patients often confuse these symptoms with normal pregnancy symptoms, so it is important to educate patients on how to identify the differences.
There are two classifications of preeclampsia.
Mild and severe preeclampsia is used to classify which treatment plan to follow. Mild preeclampsia includes new onset proteinuria and high blood pressure. A blood pressure of 140 systolic over 90 diastole (two times, 6 hours apart), would indicate mild preeclampsia. During prenatal appointments, women are asked to give a urine sample each visit. If the urine tests positive for protein the best way to check is through a 24-hour urine test. When the 24-hour sample shows more than 300 mg of protein; it is considered abnormal, and also a preeclampsia indication (Michele Davidson, 2011). Edema will usually be present in many patients, but is no longer considered a diagnostic symptom (Nicole Franzen Pfaff,
2014).
Severe preeclampsia may develop abruptly. Symptoms include; blood pressure, equal or greater than 160 systolic over 110 diastole (two times, six hours apart), protein in the urine of 500 mg or greater in a 24-hour period, decreased urine output, visual and cerebral changes, cyanosis, abdominal pain, decreased liver function, decreased platelets, and fetal growth disturbances (Michele Davidson, 2011). These are considered a medical emergency in pregnant women and they must be treated promptly. If treatment is not affective and symptoms continue preeclampsia patients are at risk for developing seizures (III, 2004). Preeclampsia can also lead to HELLP syndrome and eclampsia, which are both serious complications. When symptoms are not controlled, delivery is the only way to stop the progression of preeclampsia (III, 2004). There are other treatment measures that may be used to help with preeclampsia. Blood pressure medications may be used to control the hypertension patient. A beta blocker, labertalol, is one of the most common blood pressure medication prescribed (III, 2004). New guidelines are not allowing these medications until the blood pressure is greater or equal to 150 systolic over 100 diastole (Nicole Franzen Pfaff, 2014). Magnesium sulfate is also being used in some patients. This is used as the drug of choice to prevent seizures in pregnancy. Patients must be monitored closely on this drug (Michele Davidson, 2011).