During your clinical rotation you encounter a 40-year-old Gravida 2 Para 1+0 at 33 weeks 6 days of gestation attending ANC for the first time. She is 152 cm tall and weighs 92 kg. Her blood pressure is consistently high, at 150/105 mmHg.
She is a Musoga by tribe, separated from the father of her first child 10 years ago, and is now enjoying a new relationship with the father of the current pregnancy. She reports that she last had her blood pressure taken about 9 months ago and it was normal. She wonders if her sister, who is also pregnant, with a high blood pressure that was diagnosed at 5 months of gestation, transmitted the condition to her. She smokes but has been trying to quit since she got pregnant.
As you examine her, you find basal crepitations in the lung fields. Your investigations show proteinuria 2+ and a platelet count of 7000 /µL. Ultrasound scan shows that she is having a twin gestation. The doctor cross-checks with pharmacy and is happy that the first line medications for the management of this client are available. He prescribes 3 essential medications and requests you to administer them.
a. With two strong reasons to back your answer, give a classification of her most likely disorder (3 marks)
b. Explain circumstances that put her at risk for the disorder in b (i) above (5 marks)
c. Explain the administration for each of the 3 prescribed medications (15 marks)
d. With rationale, explain the recommendation for the continuation/discontinuation of this pregnancy