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Flashcards in Hypertensive Disorders of Pregnancy Deck (106)
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Toxemia

Preeclampsia

1

What percent of pregnancies are complicated by preeclampsia?

7-10%

2

PIH

Pregnancy induced hypertension

3

What percent of preeclampsia is mild?

75%

4

What percent of preeclampsia is severe?

25%

5

Who is at greater risk for preeclampsia (PIH)?

Primigravida, young age, multifetus, obesity, low economic status, diabetes, history, African American

6

What is a main nursing intervention with preeclampsia?

BP monitoring

7

Steady deflation

2-3 mmHg/sec

8

How should person be positioned for BP reading?

Sitting for 10 min with arm on surface

9

How much does peripheral resistance decrease by in pregnancy?

25%

10

What is the rise in total blood volume in pregnancy?

50%

11

What is the rise in cardiac output in pregnancy?

35-50%

12

What does the BP have to be for a diagnosis of preeclampsia?

140/90 X 2, 6 hours apart, less than 7 days apart after 20 weeks gestation

13

What does proteinuria have to be to diagnose preeclampsia?

1+ on dipstick

14

What is no longer part of the diagnosis for preeclampsia but you should watch for it?

Edema

15

What is the only cure for preeclampsia?

Birth of fetus and removal of placenta

16

Systemic disease that involves multiple organs and the fetus

Preeclampsia

17

Pathogenesis of preeclampsia

Begins with implantation, trophoblastic invasion of uterine spiral arteries is incomplete, spiral arterioles do not remodel to meet trophoblastic circulation

18

What is the result of preeclampsia on the fetus?

Decreased placental perfusion resulting in ischemia

19

Preeclamptics produce 10X more anti-angiogentic substances which decreases what?

Placental growth

20

Decreased placental perfusion=

Systemic endothelial cell disfunction

21

Vasospasms target which organs?

Brain, liver, and kidneys

22

Vasospasms cause decreased renal perfusion causing what?

Increased BUN, creatinine, and uric acid, decreased albumin causing edema

23

Vasospasms also cause sodium retention because of what system?

Renin angiotensin

24

Sodium retention causes what?

Edema

25

How do vasospasms cause edema?

Damaged glomeruli, albumin is lost, decreased osmotic pressure = edema

26

How does the renin-angiotensin system cause edema?

Increased fluid retention

27

What does disturbed endothelial control of vascular tone cause?

Hypertension, increased permeability, platelet aggregation, and ischemia of target organs

28

What is the BP in severe preeclampsia?

Systolic > 160 mmHG, Diastolic > 110 mmHg

29

What is the proteinuria classification of severe preeclampsia?

2+ - 3+ or >5 in 24 hour specimen