Kondisi Psikologis Primigravida dengan Preeklampsia Berat dan Future Direction Strategi Komunikasi Perawat: A Case Report

Abstract

Background. Preeclampsia is a pregnancy complication with a high risk of maternal and fetal morbidity and mortality. This case report aimed to describe primigravid pregnancies with severe preeclampsia and physical-psychological problems that impact patient-family’s decision-making for the health of the mother and fetus.
 Research Methods. This case report was conducted to improve understanding of a case primigravida pregnancies with severe preeclampsia. The stages of a case report included: defining the case; choosing a case; collecting and analyzing data; interpreting data; and reporting results. Data was collected through interviews, physical examinations, examination of health documents, discussions with patients and families, and information from other health workers—anxiety assessment using the Hamilton Rating Scale for Anxiety. Data analysis was done by reading the collected data, coding the primary data, comparing it, and summarizing it as a case presentation.
 Results. Primigravida, 33 weeks, severe preeclampsia and requires hourly monitoring. Complaints of frontal headaches, blurred vision and conveyed the results of high blood pressure examination at a clinic near the house. General condition: composmentis, blood pressure: 160/112 mmHg, N;118 x/min, R;24x/min, Temperature; 36.50 C, dry lips, oedema in the left lower extremity, MEWS score 4-5, fetal heart rate 134x/minute. Anxiety assessment with the Hamilton Rating Scale for Anxiety resulted in moderate-severe anxiety category. Husbands expressed the wishes of the mother and baby to be safe and to be born immediately with surgery.
 Conclusion. Severe preeclampsia with uncontrolled blood pressure requires appropriate treatment and intensive observation by health workers, especially nurses. Pregnancy with severe preeclampsia raises anxiety for patients and families, which risks further increasing blood pressure and threatening the fetus's well-being. Anxiety impacts interaction situations between patients, families, and caregivers, as well as family decision-making. A therapeutic communication approach by paying attention to comprehensive needs and holistic patient conditions is an effective nurse strategy for families to make maternal and fetal health decisions.