The Diagnosis criteria for Pre-eclampsia based on the ACOG guidelines and the maternal and fetal complications related.
- Discuss the Diagnosis criteria for Pre-eclampsia based on the ACOG guidelines and the maternal and fetal complications related.
- An effective health assessment incorporates not only physiological parameters; please suggest other parameters that should be considered and included on health assessments to reach maximal health potential on individuals.
- Name the different family developmental stages and give examples of each one.
- Describe family structure and function and the relationship with health care.
1. Diagnosis Criteria for Pre-eclampsia Based on ACOG Guidelines and Maternal & Fetal Complications
According to the American College of Obstetricians and Gynecologists (ACOG), pre-eclampsia is diagnosed based on the following criteria:
Diagnostic Criteria
- Gestational age: Occurs after 20 weeks of gestation in a previously normotensive woman.
- Blood Pressure: Systolic BP ≥140 mmHg or Diastolic BP ≥90 mmHg on two occasions at least 4 hours apart OR
- Systolic BP ≥160 mmHg or Diastolic BP ≥110 mmHg (severe range, confirmed within minutes).
- Proteinuria: ≥300 mg per 24-hour urine collection OR Protein/Creatinine ratio ≥0.3 OR Dipstick reading ≥2+ (only if quantitative measurement is unavailable).
- In the absence of proteinuria, diagnosis can still be made if there is new-onset hypertension with any of the following:
- Thrombocytopenia: Platelet count <100,000/μL
- Renal insufficiency: Serum creatinine >1.1 mg/dL or doubling of baseline
- Liver involvement: Elevated liver enzymes (AST/ALT ≥ twice normal range) and/or severe right upper quadrant/epigastric pain
- Pulmonary edema
- New-onset cerebral or visual disturbances (headache, scotoma, blurred vision, altered mental status, seizures in eclampsia)
Maternal Complications
- Eclampsia: Progression to seizures
- HELLP Syndrome: Hemolysis, Elevated Liver Enzymes, Low Platelets
- Disseminated Intravascular Coagulation (DIC)
- Stroke (Cerebral hemorrhage or infarction)
- Acute renal failure
- Placental abruption
- Pulmonary edema
- Cardiopulmonary failure
Fetal Complications
- Fetal growth restriction (FGR/IUGR) due to placental insufficiency
- Preterm birth due to early delivery for maternal/fetal indications
- Oligohydramnios (low amniotic fluid)
- Stillbirth
- Neonatal respiratory distress syndrome (RDS) if delivered prematurely
2. Additional Health Assessment Parameters for Holistic Care
An effective health assessment should include not only physiological but also psychosocial, cultural, and environmental aspects to achieve maximal health potential.
Key Additional Parameters:
- Psychosocial Health: Stress levels, coping mechanisms, mental health screening (depression, anxiety, PTSD)
- Cultural & Spiritual Considerations: Beliefs regarding health and treatment, religious influences on care choices
- Socioeconomic Status: Access to healthcare, insurance coverage, financial stability
- Lifestyle Factors: Nutrition, physical activity, substance use (alcohol, tobacco, illicit drugs)
- Environmental Factors: Living conditions, exposure to pollutants/toxins, workplace hazards
- Support System: Family dynamics, caregiver availability, presence of intimate partner violence (IPV)
- Cognitive & Developmental Considerations: Memory, executive function, learning disabilities in pediatrics or geriatrics
- Health Literacy: Understanding of medical conditions and adherence to treatments
- Genetic & Family History: Risk factors for hereditary diseases
3. Family Developmental Stages & Examples
Families go through different developmental stages, which influence health care needs and nursing interventions.
| Stage | Example |
|---|---|
| 1. Beginning Family (Marriage/Pre-parenthood) | Newly married couple planning for a family |
| 2. Childbearing Family | Birth or adoption of the first child, adjusting to parenting roles |
| 3. Family with Preschool Children | Managing child’s socialization, education, and discipline |
| 4. Family with School-Age Children | Supporting academic and social activities, managing behavioral issues |
| 5. Family with Adolescents | Encouraging independence, managing risk-taking behaviors |
| 6. Launching Stage (Young Adults Leaving Home) | Children leave for college, work, or marriage |
| 7. Middle-Aged Parents (Empty Nest Stage) | Reinvesting in marriage, career changes, preparing for retirement |
| 8. Aging Family (Retirement to Death of Both Spouses) | Adjusting to aging, chronic illness, loss of spouse, and end-of-life care |
4. Family Structure, Function & Relationship with Health Care
Family Structure
- Nuclear Family: Parents and children living together
- Extended Family: Includes grandparents, aunts, uncles, etc.
- Single-Parent Family: One parent raising children
- Blended Family: Step-parents and step-siblings from remarriages
- Same-Sex Parents: LGBTQ+ parents raising children
- Grandparent-Headed Family: Grandparents raising grandchildren
- Communal Family: Non-biologically related individuals cohabiting as a family unit
Family Function & Its Impact on Health Care
Families play a vital role in healthcare decision-making, emotional support, and caregiving:
- Health Promotion & Disease Prevention: Families influence diet, exercise, and preventive health behaviors.
- Caregiving & Chronic Illness Management: Families provide care for elderly or chronically ill members.
- Emotional & Psychological Support: A strong support system can improve mental health and treatment adherence.
- Health-Seeking Behavior: Family attitudes determine whether individuals seek medical care promptly.
- Cultural & Religious Influences: Families shape beliefs about illness, treatment preferences, and end-of-life care.
Nursing & Healthcare Implications
- Nurses should assess family dynamics to identify barriers to care.
- Family-centered approaches improve patient adherence, satisfaction, and health outcomes.
- Interdisciplinary care teams should involve family members in treatment planning and education.