Background Information
One of the problematic issues still occurring in the modern hospital setting is maternal hypertension. This condition occurs as a physiological reaction following cesarean delivery with spinal anesthesia (Xu et al., 2019). It has been established that maternal hypertension contributes considerably to adverse pregnancy outcomes such as vomiting, nausea, vertigo, and even cardiovascular failure (Xu et al., 2019). Furthermore, other negative consequences and complications may include impaired placental perfusion, which leads to the possibility of fetal acidification, hypoxia, and postnatal brain damage (Xu et al., 2019). Hence, maternal hypertension has life-threatening consequences for a woman in labor and her child.
However, researchers of medicine have already tried to establish solutions for the issue, which could be discussed further. As such, Xu et al. (2019) proposes norepinephrine in contrast with phenylephrine, the current standardized vasopressor often used to address maternal hypotension in women enduring cesarean section birth under spinal anesthesia. Wang et al. (2019) add that a supplemental dose of norepinephrine should be used to increase maternal and newborn safety during cesarean delivery under spinal anesthesia in patients with preeclampsia and hypotension. However, other researchers highlight that vasopressor medications negatively affect the cardiovascular system (Ryu et al., 2019). They state that in the realm of labor and delivery anesthesia, the ideal vasopressor should not concentrate only on preserving maternal blood pressure control and minimizing maternal problems like vomiting. This medication must also have minimal negative effects on uteroplacental blood flow and newborn health outcomes (Ryu et al., 2019). Thus, the choice of the most appropriate medication that would improve the consequences of labor is currently an important question concerning maternal hypertension.
The Significance of the Topic to Nursing Practice
The topic of maternal hypertension is widely significant for nursing practice. As such, doctors are not the only medical professionals that contribute to a child’s and mother’s safety and welfare in the maternity ward. Childbirth nurses are also essential to the delivery and treatment of newborns, and they typically help the doctor throughout labor. Delivery nurses collaborate with gynecologists and other doctors in childbirth rooms, aiding with prenatal and postnatal care. Nurses are frequently responsible for collaborating with doctors to develop a specific birthing program for each woman in order to guarantee that each pregnancy is safe for both the mother and the child. Before birth, nurses usually communicate about the labor procedure with the mother and educate her on what to expect. Hence, it might happen that a nurse would be responsible for a patient predisposed to preeclampsia, as well as a nurse might face the problem of maternal hypertension during a labor operation. As a result, nurses must be skilled, informed, and trained as medical professionals to think rationally, make appropriate nursing judgments, and act fast in the case of maternal hypertension.
PICOT Questions
In accordance with the provided background information, several PICOT questions could be supposed:
- In pregnant female patients with chronic hypertension (P), how does norepinephrine (I) compared to phenylephrine (C) influence child delivery outcomes and maternal health (O) over three days (T)?
- In pregnant female patients over 45 or older (P), how does norepinephrine (I) compared to phenylephrine (C) influence child delivery outcomes and maternal health (O) over three months (T)?
- In pregnant female patients (P), how does norepinephrine (I) compared to other vasopressors (C), influence uteroplacental blood flow and newborn health outcomes (O)over three days (T)?
References
Ryu, C., Choi, G. J., Park, Y. H., & Kang, H. (2019). Vasopressors for the management of maternal hypotension during cesarean section under spinal anesthesia. Medicine, 98(1). Web.
Wang, X., Mao, M., Liu, S., Xu, S., & Yang, J. (2019). A comparative study of bolus norepinephrine, phenylephrine, and ephedrine for the treatment of maternal hypotension in parturients with preeclampsia during cesarean delivery under spinal anesthesia.Medical Science Monitor, 25, 1093–1101. Web.
Xu, S., Shen, X., Liu, S., Yang, J., & Wang, X. (2019). Efficacy and safety of norepinephrine versus phenylephrine for the management of maternal hypotension during cesarean delivery with spinal anesthesia. Medicine, 98(5). Web.