Question

You have been called for a young female in labor. She is lying on the floor in obvious distress from labor pains. While you are assessing her for crowning, your partner is getting a set of vital signs. She tells you that she is getting dizzy and nauseated. Vital signs are pulse rate 120, respiratory rate 22, and blood pressure 98/62. You should be concerned that she has:

a. Preeclampsia
b. Hypertension
c. Hypovolemia
d. Normal pregnancy symptoms

Answer 1

The woman in labor showing signs of dizziness, nausea, and with a pulse rate of 120, respiratory rate of 22, and blood pressure of 98/62 should be considered as potentially having hypovolemia, which is a decreased volume of circulating blood in the body.

Step-by-step explanation:

You should be concerned that she has hypovolemia. The patient's signs and symptoms, including dizziness, nausea, high pulse rate, increased respiratory rate, and low blood pressure, are suggestive of reduced blood volume. In the context of labor, these could potentially indicate complications such as bleeding or dehydration. While conditions like preeclampsia and hypertension are relevant considerations in pregnancy, the vital signs (particularly the low blood pressure) and her symptoms lean more towards hypovolemia than the high blood pressure associated with preeclampsia or chronic hypertension.

In pregnancy, normal physiological changes can cause a mild increase in heart rate and lower peripheral vascular resistance, potentially leading to lower blood pressure. However, the combination of symptoms and vital signs here is concerning and warrants prompt medical attention to ensure the safety of both the mother and the fetus.