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NUR 332 > HTN disorders > Flashcards

HTN disorders Flashcards

1
Q

gestational hypertension

A

SBP greater than or equal to 140
DBP greater than or equal to 90

occurs after 20 weeks
No proteinuria

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2
Q

What occurs if blood pressure is still elevated Six weeks after delivery?

A

diagnosed with chronic hypertension

Should normally resolved within 6 to 12 weeks postpartum

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3
Q

preeclampsia

A

Increased blood pressure after 20 weeks with proteinuria

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4
Q

risk factors of preeclampsia

A

Chronic hypertension
Renal disease
Diabetes
Family history
Less than 20 years old
Greater than 40 years old
BMI greater than 30

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5
Q

Patho of preeclampsia

A

Vasoconstriction causes decreased renal perfusion

Intravascular fluid redistribution

Narrowing of endometrium

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6
Q

treatment for preeclampsia

A

Aspirin at 12–21 weeks at risk

Avoid ace inhibitors and diuretics

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7
Q

maternal symptoms of preeclampsia

A

Epigastric pain – liver area
Scotoma, blurred vision, headache
Hyperreflexia
Proteinuria
Facial edema, pulmonary edema
Ascites, pleural effusions
Oliguria

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8
Q

Labs for preeclampsia

A

CBC
AST, ALT, LDH
BUN/Cr
Glucose
Uric acid
Type and screen
** 24 hour protein/creatinine clearance

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9
Q

Mild preeclampsia

A

SBP greater than or equal to 140
DBP greater than equal to 90
On two occasions, at least four hours apart when previously normal

Proteinuria greater than 300/24 hours

Proteins/creatinine clearance greater than or equal to 0.3

Positive urine dipstick

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10
Q

mild eclampsia without proteinuria

A

Platelets less than 100,000
Cerebral vision changes
Creatinine greater than 1.1 or doubled concentration.
Pulmonary edema
Liver enzymes double than normal

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11
Q

treatment for Mild preeclampsia

A

Frequent rest
Lateral position
Daily blood pressure and weight, FMC
Bedrest in hospital
Moderate to high protein and sodium

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12
Q

severe preeclampsia

A

SBP greater than or equal to 160
DBP greater than or equal to 110
on two occasions, four hours apart, while on bedrest

Proteinuria greater than 300/2 hours
Platelets less than 100,000

Severe, persistent, epigastric pain
Liver enzymes double the normal

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13
Q

treatment for severe preeclampsia

A

Complete bed rest
Magnesium sulfate
Corticosteroids
Antihypertensives-labetalol/hydralazine

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14
Q

what to do if SBP remains greater than 160 or DBP greater than 105

A

IV. Labetalol.
IV. Hydralazine.
Oral nifedipine

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15
Q

contraindication for IV labetalol

A

Asthma

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16
Q

contraindication for IV hydralazine and oral Nifedepine

A

Tachycardia

17
Q

medication for prevention of seizures

A

Magnesium sulfate
Given for at least 24 hours postpartum

18
Q

Normal magnesium sulfate side effects

A

headache
Nausea/vomiting
Flushing
Sedation/tired
Muscle weakness

19
Q

magnesium sulfate toxicity

A

Decreased or absent reflexes
Decreased respiratory rate
Change in LOC
Fetal HR less than 110

Increased CR, AST/ALT
Decreased platelets

20
Q

antidote for magnesium toxicity

A

Calcium gluconate

21
Q

Eclampsia

A

obstetric emergency
Onset of seizure, secondary due to preeclampsia

emergency delivery if fetal hypoxia/abruption

22
Q

HELLP syndrome

A

hemolysis
Elevated liver enzymes due to obstructed blood flow, liver distention
Low platelet count < 100,000

23
Q

s/sx HELLP syndrome

A

Nausea/vomiting
flu, like symptoms, epigastric pain

24
Q

Treatment for HELLP syndrome

A

Steroids and delivery of fetus after 48 hours if less than 34 weeks

25
Q

chronic hypertension

A

SBP greater than or equal to 140
DBP greater than or equal to 90

Before pregnancy, 20th week or after sixth week postpartum

26
Q

Treatment for chronic HTN

A

bedrest, left side lying
Increase protein and sodium in diet
nifedipine, labetalol
Labs – Preeclampsia panel

27
Q

chronic hypertension with super imposed preeclampsia

A

Sudden increase in previously control blood pressure
New proteinuria
Upper extremity edema
Increase uric acid

NUR 332 (14 decks)

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