Flashcards in Hypertensive Disorders of Pregnancy Deck (106)
What percent of pregnancies are complicated by preeclampsia?
Pregnancy induced hypertension
What percent of preeclampsia is mild?
What percent of preeclampsia is severe?
Who is at greater risk for preeclampsia (PIH)?
Primigravida, young age, multifetus, obesity, low economic status, diabetes, history, African American
What is a main nursing intervention with preeclampsia?
How should person be positioned for BP reading?
Sitting for 10 min with arm on surface
How much does peripheral resistance decrease by in pregnancy?
What is the rise in total blood volume in pregnancy?
What is the rise in cardiac output in pregnancy?
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
What does proteinuria have to be to diagnose preeclampsia?
1+ on dipstick
What is no longer part of the diagnosis for preeclampsia but you should watch for it?
What is the only cure for preeclampsia?
Birth of fetus and removal of placenta
Systemic disease that involves multiple organs and the fetus
Pathogenesis of preeclampsia
Begins with implantation, trophoblastic invasion of uterine spiral arteries is incomplete, spiral arterioles do not remodel to meet trophoblastic circulation
What is the result of preeclampsia on the fetus?
Decreased placental perfusion resulting in ischemia
Preeclamptics produce 10X more anti-angiogentic substances which decreases what?
Decreased placental perfusion=
Systemic endothelial cell disfunction
Vasospasms target which organs?
Brain, liver, and kidneys
Vasospasms cause decreased renal perfusion causing what?
Increased BUN, creatinine, and uric acid, decreased albumin causing edema
Vasospasms also cause sodium retention because of what system?
Sodium retention causes what?
How do vasospasms cause edema?
Damaged glomeruli, albumin is lost, decreased osmotic pressure = edema
How does the renin-angiotensin system cause edema?
Increased fluid retention
What does disturbed endothelial control of vascular tone cause?
Hypertension, increased permeability, platelet aggregation, and ischemia of target organs
What is the BP in severe preeclampsia?
Systolic > 160 mmHG, Diastolic > 110 mmHg