Hypertension in Pregnancy Flashcards

1
Q

What is the most common medical complication reported during pregnancy?

A

Hypertension.

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2
Q

Which race is more likely to die of preeclampsia?

A

African american.

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3
Q

What is the definition of hypertension in pregnant women?

A

Diastolic over 15mmHg normal baseline
Systolic over 30mmHg normal baseline
Over 140/90

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4
Q

How is chronic hypertension classified during pregnancy?

A

Hypertension that predates the pregnancy or lasts 42 days postpartum.

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5
Q

What is pregnancy induced hypertension (PIH)?

A

Onset of hypertension during pregnancy after 20 weeks or in the first 24 hours after birth with or without symptoms of hypertension during pregnancy

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6
Q

When is chronic hypertension present?

A

Before the pregnancy or before week 20 of pregnancy

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7
Q

What is chronic hypertension with superimposed preeclampsia?

A

Women who have chronic hypertension may aquire preeclampsia or exlampsia.

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8
Q

What is transient hypertension?

A

Gestational hypertension with no signs of preclampsia and present at the time of birth; resolves after 12 weeks.

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9
Q

What is preeclampsia?

A

Pregnancy specific syndrome that occurs 20 weeks after gestation with gestational HTN and proteinuria.

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10
Q

What is eclampsia?

A

The occurense of seizures in a woman with preeclampsia that is not attributed to anything else.

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11
Q

Can PIH turn into preeclampsia?

A

Yes

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12
Q

What is the main difference between PIH and preeclampsia?

A

There is protein in the urine in preeclampsia-

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13
Q

What are blood pressure readings for severe preeclampsia?

A

Over 160/110

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14
Q

What is exlampsia?

A

Seizure activity or coma in women with preeclampsia.

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15
Q

What type of seizure happens during Eclampsia and why?

A

Grand Mal- there is no perfusion to the brain because of vasospasms.

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16
Q

What can happen to the mother and fetus if eclampsia is not treated?

A

Cerebral hemorrhage, fetus can be hypoxic, placental abruption, and death.

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17
Q

What are some causes of pre/eclampsia?

A

Heredity, physiological, psychological, nutritional excess or decifiencies, endocrine, sometimes unknown.

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18
Q

What are some risk factors women may have to develop preeclampsia?

A

Primigravidity, multifetal pregnancy, obesity, before age 19, after age 40.

19
Q

What is the patho of preeclampsia?

A

Arteriolar vasospasms that diminish the diameter of blood vessels, with decreases blood flow to organs and increases BP.

20
Q

What organs can be depressed from preeclampsia?

A

Placenta, kidneys, liver, and brain.

21
Q

What are some risk factors for PIH?

A

HTN history, diabetes, multiple pregnancies, nutrition, family history, pverty, age

22
Q

What does generalized arterial vasoconstriction lead to?

A

Poor renal perfusion, decreased utero placental perfusion, damaged vascular walls, increased platelets, seizures, dehydration

23
Q

What is the “classic triad” of preeclampsia?

A

Hypertension, edema, and proteinuria.

24
Q

Where is edema usually seen in pregnant women?

A

Above the waist- fingers, face, extremities

25
Q

What is proteinuria?

A

protein in the urine- usually a late sign

26
Q

What are some other signs of preclampsia?

A

Headaches, visual disturbances, right upper quadrant pain (epigastric), n/v, oliguria, hyper reflexia, irritability, cyanosis, pulmonary edema.

27
Q

What are some care techniques for seizures?

A

Keep the patient safe, keep bed rails up, record when it starts, stops, and what happened, use O2, stay with pt, check baby.

28
Q

What is HELLP syndrome?

A

Hemolysis, Elevated Liver enzymes, Low Platelets.

29
Q

What are some symptoms of HELLP?

A

BP of 160/110. +3 proteinuria, <100k platelets, decreased urine output, visual disturbances.

30
Q

What is HELLP syndrome associated with?

A

Placental abruption, renal failure, pulmonary edema, ruptured liver hematoma

31
Q

What should the nurse assess for preeclampsia?

A

Interview for HX, PE, Dependent edema, reflexes, Lab tests

32
Q

What is the prevention for PIH?

A

Prenatal care, teaching, high protein, low sodium diet, vitamins, low dose aspirin as rx

33
Q

What is the treatment of preeclampsia?

A

Home care, nurse should assess home environment, modified bed rest, vital signs

34
Q

What is the treatment for severe preeclampsia?

A

Daily weights, urine dipstick, strict i & o, fetal activity, increase fluids, homans sign, seizure precaution.

35
Q

How should the fetus be assessed?

A

FHR, activity, non stress test, stress test, estriol testing

36
Q

What is estriol testing?

A

checking for function of placenta

37
Q

What is magnesium sulfate given for?

A

anticonvulsant to be given for neuromuscular irritability and fetal neuro protection

38
Q

What are side effects of Magnesium sulfate?

A

flushing, sweating, depressed CNS, flaccid muscles, resp depression, fetal bradycardia, respiratory arrest

39
Q

What is ankle clonus?

A

Dorsiflexion of the foot three times in rapid succession and it should not move

40
Q

What does evidence show helps when magnesium sulfate is given 2 hours before delivery?

A

reduces risk for cerebral palsy

41
Q

What is labetalol?

A

a beta blocker that decreases the nerve response in the heart and decreases pulse and BP

42
Q

What is apresoline?

A

A vasodilator that increases cardiac output

43
Q

What is aldomet?

A

used for maintenance of hypertension

44
Q

What is procardia?

A

calcium channel blocker to decrease systemic vascular resistance