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hypertension in pregnancy Flashcards

1
Q

Hypertension (HTN)

A

140/90

A systolic pressure greater than or equal to 140 mmHg
A diastolic pressure greater than or equal to 90 mmHg

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2
Q

systolic

A

the force the blood exerts on arterial walls as the heart contracts and sends blood to periphery

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3
Q

diastolic

A

the residual pressure exerted on the arteries as the heart relaxes between beats

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4
Q

Dx as:

essential HTN

A

hypertension due to a genetic cause

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5
Q

Dx as:

secondary HTN

A

hypertension due to an underlying medical condition

maybe a renal, neurological, endocrine origin

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6
Q

Hypertension can increase the risk for the following:

A
  • heart disease
  • stroke
  • TIA
  • renal failure
  • MI
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7
Q

Hypertensive disorders are not very common complication in pregnancy. True or false.

A

False.

Hypertensive disorders in pregnancy are one of the most common disorders in pregnancy affecting 10% of women

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8
Q

HTN is he 2nd leading cause of maternal death

A

incidence has increased has increased more than 50% over 30 years

d/t western diet and process foods

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9
Q

Four categories of Hypertension in pregnancy

A
  • Chronic HTN
  • Gestational HTN
  • Chronic HTN w/ Superimposed Preeclampsia
  • Preeclampsia
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10
Q

chronic hypertension

A
  • dx of HTN prior to conception
    or
  • dx prior to 20 weeks gestation

BP greater or equal to 140/90

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11
Q

gestational hypertension

A
  • dx with HTN **after 20 weeks **gestation without any other signs/symptoms of preeclampsia

BP greater than or equal to 140/90

-

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12
Q

Chronic Hypertension with Superimposed Preeclampsia

A
  • dx with HTN prior to 20 weeks gestation
    and then…
    -develop proteinuria after 20 weeks

~dx with HTN and proteinuria prior to 20
weeks gestation and then…
-develop a sudden exacerbation of HTN

&/OR

-have sudden onset of ‘typical’ preeclamptic
manifestations (↑ liver enzymes, ↓ platelets,
RUQ pain, HA, vision changes pulmonary edema,
renal insufficiency)

&/OR

-have sudden, substantially increased protein
excretion

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13
Q

preeclampsia

A
  • Hypertensive, multisystem disorder of unknown etiology in pregnancy
  • Pregnancy specific syndrome of reduced organ perfusion secondary to vasospasm and endothelial activation
  • new onset of HTN after 20 weeks of gestation with…
    - ******* with 2 BPs greater than or equal to 140/90 mmHg taken at least 4 hours apart *
    &/or
    - proteinuria ** greater than or equal to 3 grams over 24 hours **

&/or

  • new onset systemic disease symptoms
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14
Q

diagnosing considerations for preeclampsia

A
  • disease presentation varies with timing of symptoms onset

-proteinuria is no longer an absolute criteria

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15
Q

risk factors of preeclampsia & eclampsia

A
  • nulliparity
  • younger than 20 or older than 35
  • obese
  • african american
  • multiple gestation
  • hx of preeclampsia or eclampsia
  • family hx of preeclampsia
  • pre-pregnancy CHTN, kidney disease, lupus, diabetes
  • gestaional diabetes
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16
Q

Early-Onset Preeclampsia

A
  • symptom onset prior to 34 weeks
  • associated with increase severity of disease
  • poor placentation (formation, structure, placement)
  • see abnormal uterine artery dopplers and increase incidence of IUGR & preterm birth
17
Q

Late-onset Preeclampsia

A
  • symptom onset after 34 weeks
  • more favorable maternal/fetal outcomes
  • possinly triggered by abnormal imune response
18
Q

New-Onset Postpartum Preeclampsia

A
  • symptom onset up to 8 weeks PP
  • different & complicated clinical presentation
  • unknown etiology if nothing present during the pregnancy
19
Q

A women is can be diagnosed with mild preeclampsia, what does nurse know is incorrect about the statement.

A

The nurse knows that mild preeclampsia is an old diagnostic term. There is no in between, a patient either does or doesn’t have preeclampsia.

The term subjectively undermineded the disease’s progression potential.

20
Q

Risk factors for Preeclampsia & Eclampsia

A
  • nulliparity
  • younger than 20 or older than 35
  • obesity
  • African American
  • Multiple gestation
  • family hx of preeclampsia
  • pre pregnancy -> CHTN, kidney disease, lupus, diabetes
  • hx of preeclampsia or eclapsia
  • gestational diabetes
21
Q

normal physiology

A
  • generalized vasodilated state, in early pregnancy
    - (BP returns to pre-pregnant levels at term)
  • decreased peripheral vascular resistance and BP
  • increased blood volume, cardiac output, and renal blood flow
22
Q

when does pahology of the disease begin?

A

at conception

23
Q

1st stage

A

placental abnormalities

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