Introduction
Oksana, 39, is 24 weeks pregnant with her first child after recently immigrating to Canada from Ukraine with her husband. Married for two years, she is typically accompanied by her supportive spouse to prenatal visits. At today’s appointment, she reports a headache and swelling in her hands, expressing concern that work-related stress may affect her baby. Her job involves frequent travel and dining with clients. Assessment findings include blood pressure of 142/90, pulse 80, respirations 16, and urine protein +1.
Her status characterizes Oksana’s pregnancy case as an immigrant to Canada, her first pregnancy at the age of 39, the presence of hypertension, preeclampsia, and exposure to workplace stress, while being supported by her husband. When analyzing the particularities of a pregnant client’s case, it is essential to provide a rationale and explanation for the teaching plan aimed at achieving one of the prioritized educational goals. The investigation of vital signs, environment, social justice, and potential risks to Oksana’s health and pregnancy success highlights the need to address hypertension risks.
The priority of this learning goal over stress-coping needs, nutrition, and activity adjustment is validated by the high risks of complications for pregnancy due to the hypertension issue. Furthermore, the teaching plan for hypertension is inherently intertwined with stress management and a healthy lifestyle, which is why this issue should be addressed first. In this regard, this paper aims to articulate the learning needs of the client, focusing on lowering her blood pressure to prevent complications for both the client and her future child.
Description of the Priority Health Concern
The prioritized health concern for Oksana is related to her hypertension management learning needs. She has an increased blood pressure of 142/90, which suggests level 1 hypertension. According to statistical data, hypertension in pregnancy becomes common due to demographic and social changes. As researchers state, “given that current trends indicate that the incidence of HDP continues to increase as a result of advanced age at first pregnancy and increased prevalence of obesity and other cardiometabolic risk factors” (Garovic et al., 2022, p. 22).
The prevalence of the issues among the population of pregnant women justifies the prioritization of this learning goal within the proposed prenatal teaching plan since”>10% of women will experience at least one hypertensive pregnancy” (Honigberg et al., 2019, p. 2744). Unaddressed hypertension is associated with preeclampsia, which is evident in the client due to her upper limb puffiness and imposes additional risks to the health of the child and the mother (Honigberg et al., 2019). A range of complications and adverse effects of the condition on the health of the pregnant woman and the fetus necessitate acknowledgment in the context of this teaching plan.
Effects the Health Concern Has on the Pregnant Person
Hypertension implies significant health risks for Oksana due to the possibility of concurrent complications associated with her age, as well as the objective vital signs reported in the case study. Research shows that hypertension leads to cardiovascular impairments and might become a cause of morbidity and mortality for mothers (Tita et al., 2022). In particular, some of the adverse outcomes of hypertension in pregnancy for the mother include “cerebrovascular accidents and cardiomyopathy, which now account for up to half of all maternal deaths” (Garovic et al., 2022, p. 22).
Furthermore, hypertension is one of the causes of stroke, which occurs in pregnancy. According to research, “pregnancy-related stroke hospitalizations increased >60% from 1994 to 2011, and HDP-associated stroke rates increased 2-fold compared with non-HDP-related stroke” (Garovic et al., 2022, p. 22). Thus, the prevalence and severity of risks of hypertension for Oksana’s short- and long-term health outcomes necessitate accurate and prioritized management of the issue with an emphasis on patient education.
Effects on the Fetus/Newborn
In addition to the direct negative impact of hypertension on the health of a pregnant woman, the development and health of the fetus might also be impaired under the influence of high blood pressure. In particular, the dysfunction in blood supply to the placenta associated with hypertension in the mother might reduce the flow of oxygen and nutrients to the fetus, which is risky in multiple developmental aspects (Garovic et al., 2022). Furthermore, research demonstrates that the administration of antihypertensive medications might reduce the growth rate of the fetus and impede its healthy development (Tita et al., 2022). Thus, some of the most severe effects of the analyzed health concern on a newborn are premature birth or insufficient weight at birth. Therefore, given the scope of risks for the fetus, Oksana’s teaching plan should include safe treatment and management strategies to ensure benefits for both the mother and the baby.
Potential Postpartum Concerns that Need to Be Considered
Postpartum, hypertension implications might persist and should be addressed within the teaching plan. Indeed, Garovic et al. (2022) state that approximately 8% of women who did not have hypertension before pregnancy are likely to have it after delivery. In addition, individuals with a history of preeclampsia are 50% likely to develop hypertension postpartum (Garovic et al., 2022).
Thus, such persistence of the problem postpartum implies Oksana’s exposure to commonly observed comorbidities risks, such as stroke or heart attack (Honigberg et al., 2019; Tita et al., 2022). Eliminating the causes of hypertension through a healthy diet, an active lifestyle, regular blood pressure monitoring, stress reduction, and proper heart function facilitation is essential for Oksana’s long-term health benefits. For that matter, it is essential to address hypertension management within the client’s teaching plan.
Conclusion
In summary, the analyzed case of Oksana allows us to state that, given the client’s vital signs, pregnancy development, and environmental and psychosocial particularities, the issue of hypertension is deemed the most urgent one. Indeed, the exploration of this health concern’s effects on the pregnant woman and the fetus demonstrates high risks of morbidity and mortality. For that matter, it is vital to educate the client about effective strategies for managing hypertension and minimizing factors that contribute to its development. Through the implementation of the proposed teaching plan, Oksana will be able to achieve her goal of lowering her blood pressure and increasing the chances of a safe pregnancy and a healthy life for herself and her child.
References
Garovic, V. D., Dechend, R., Easterling, T., Karumanchi, S. A., McMurtry Baird, S., Magee, L. A., Rana, S., Vermunt, J. V., & August, P. (2022). Hypertension in pregnancy: Diagnosis, blood pressure goals, and pharmacotherapy: A scientific statement from the American Heart Association. Hypertension, 79(2), 21-41.
Honigberg, M. C., Zekavat, S. M., Aragam, K., Klarin, D., Bhatt, D. L., Scott, N. S., Peloso, G. M., & Natarajan, P. (2019). Long-term cardiovascular risk in women with hypertension during pregnancy. Journal of the American College of Cardiology, 74(22), 2743-2754.
Tita, A. T., Szychowski, J. M., Boggess, K., Dugoff, L., Sibai, B., Lawrence, K., Hughes, B. L., Bell, J., Aagaard, K., Edwards, R. K., Gibson, K., Haas, D. M., & Andrews, W. W. (2022). Treatment for mild chronic hypertension during pregnancy. New England Journal of Medicine, 386(19), 1781-1792.