Chapter 6: Knowledge Integration
Case Study 3: Pregnant Adult Client (continued)
1. What needs to be considered when interpreting the vital signs findings of this pregnant client?
- Even though the client’s reason for seeking care is shortness of breath, the Sp02 saturation is within the normal range and the respiratory rate is in the normal range. In the third trimester, it is common for the fetus to push against the diaphragm, causing it to raise and put pressure on the lungs resulting in the pregnant woman feeling short of breath.
- When measuring respiration, the healthcare provider assesses the depth of breathing: breathing is usually shallow in later-term pregnancy.
- Always take a fetal heart rate when taking a pregnant woman’s vital signs.
2. Which vital sign findings are considered abnormal for this pregnant client? What medical terminology is used to define/label these findings?
The blood pressure is elevated because the systolic pressure is 134 and the diastolic pressure is 90. Healthcare providers should first repeat the blood pressure reading for accuracy. They should also review the pregnant woman’s blood pressure levels pre-pregnancy and during previous pregnancies to determine the significance of these values. These considerations are important because slightly high systolic and diastolic blood pressure levels in later-term pregnant women can require an urgent referral for an obstetrical assessment.
The blood pressure is repeated on both arms after the client is at rest for five minutes to confirm accuracy.
1435 hrs, August 14, 2018
- BP 132/90 mm Hg right arm in sitting position, P 92 (radial)
- BP 128/88 mm Hg left arm in sitting position, P 88 (radial)
Try to answer the following questions. Write your answers on a piece of paper.
- Which blood pressure do you record?
- Is the variation between the arms of concern?