Flashcards in Hypertension in Pregnancy Deck (44):
What is the most common medical complication reported during pregnancy?
Which race is more likely to die of preeclampsia?
What is the definition of hypertension in pregnant women?
Diastolic over 15mmHg normal baseline
Systolic over 30mmHg normal baseline
How is chronic hypertension classified during pregnancy?
Hypertension that predates the pregnancy or lasts 42 days postpartum.
What is pregnancy induced hypertension (PIH)?
Onset of hypertension during pregnancy after 20 weeks or in the first 24 hours after birth with or without symptoms of hypertension during pregnancy
When is chronic hypertension present?
Before the pregnancy or before week 20 of pregnancy
What is chronic hypertension with superimposed preeclampsia?
Women who have chronic hypertension may aquire preeclampsia or exlampsia.
What is transient hypertension?
Gestational hypertension with no signs of preclampsia and present at the time of birth; resolves after 12 weeks.
What is preeclampsia?
Pregnancy specific syndrome that occurs 20 weeks after gestation with gestational HTN and proteinuria.
What is eclampsia?
The occurense of seizures in a woman with preeclampsia that is not attributed to anything else.
Can PIH turn into preeclampsia?
What is the main difference between PIH and preeclampsia?
There is protein in the urine in preeclampsia-
What are blood pressure readings for severe preeclampsia?
What is exlampsia?
Seizure activity or coma in women with preeclampsia.
What type of seizure happens during Eclampsia and why?
Grand Mal- there is no perfusion to the brain because of vasospasms.
What can happen to the mother and fetus if eclampsia is not treated?
Cerebral hemorrhage, fetus can be hypoxic, placental abruption, and death.
What are some causes of pre/eclampsia?
Heredity, physiological, psychological, nutritional excess or decifiencies, endocrine, sometimes unknown.
What are some risk factors women may have to develop preeclampsia?
Primigravidity, multifetal pregnancy, obesity, before age 19, after age 40.
What is the patho of preeclampsia?
Arteriolar vasospasms that diminish the diameter of blood vessels, with decreases blood flow to organs and increases BP.
What organs can be depressed from preeclampsia?
Placenta, kidneys, liver, and brain.
What are some risk factors for PIH?
HTN history, diabetes, multiple pregnancies, nutrition, family history, pverty, age
What does generalized arterial vasoconstriction lead to?
Poor renal perfusion, decreased utero placental perfusion, damaged vascular walls, increased platelets, seizures, dehydration
What is the "classic triad" of preeclampsia?
Hypertension, edema, and proteinuria.
Where is edema usually seen in pregnant women?
Above the waist- fingers, face, extremities
What is proteinuria?
protein in the urine- usually a late sign
What are some other signs of preclampsia?
Headaches, visual disturbances, right upper quadrant pain (epigastric), n/v, oliguria, hyper reflexia, irritability, cyanosis, pulmonary edema.
What are some care techniques for seizures?
Keep the patient safe, keep bed rails up, record when it starts, stops, and what happened, use O2, stay with pt, check baby.
What is HELLP syndrome?
Hemolysis, Elevated Liver enzymes, Low Platelets.
What are some symptoms of HELLP?
BP of 160/110. +3 proteinuria, <100k platelets, decreased urine output, visual disturbances.
What is HELLP syndrome associated with?
Placental abruption, renal failure, pulmonary edema, ruptured liver hematoma
What should the nurse assess for preeclampsia?
Interview for HX, PE, Dependent edema, reflexes, Lab tests
What is the prevention for PIH?
Prenatal care, teaching, high protein, low sodium diet, vitamins, low dose aspirin as rx
What is the treatment of preeclampsia?
Home care, nurse should assess home environment, modified bed rest, vital signs
What is the treatment for severe preeclampsia?
Daily weights, urine dipstick, strict i & o, fetal activity, increase fluids, homans sign, seizure precaution.
How should the fetus be assessed?
FHR, activity, non stress test, stress test, estriol testing
What is estriol testing?
checking for function of placenta
What is magnesium sulfate given for?
anticonvulsant to be given for neuromuscular irritability and fetal neuro protection
What are side effects of Magnesium sulfate?
flushing, sweating, depressed CNS, flaccid muscles, resp depression, fetal bradycardia, respiratory arrest
What is ankle clonus?
Dorsiflexion of the foot three times in rapid succession and it should not move
What does evidence show helps when magnesium sulfate is given 2 hours before delivery?
reduces risk for cerebral palsy
What is labetalol?
a beta blocker that decreases the nerve response in the heart and decreases pulse and BP
What is apresoline?
A vasodilator that increases cardiac output
What is aldomet?
used for maintenance of hypertension