Flashcards in Medical Complications Deck (25):
Preexisting diabetes, pregnancy leads to worsening
No diabetes at all leading to gestational diabetes
140/90 or greater
Elevated BP, excessive weight gain, albuminemia
new onset of HTN and either proteinuria or end organ dysfunction after 20 weeks gestation in previously normotensive pt
patho of preeclampsia
Spiral arteries from myometrium become thickened, wider, and spiraled in preparation for the placenta
Something goes wrong with spiral arteries, so body releases enzymes to make endothelium of spiral arteries behave normally. This has systemic effect leading to increased BP
schistocytes-broken up RBCs seen
systolic bp >140 or diastolic >90 on two occasions at least 4 hours apart after 20 weeks gestation
if systolic>160 or diastolic >110, confirmed in minutes
proteinuria >0.3 grams in 24 hours
development of grand mal seizures in a pt with preeclampsia, in the absence of any neuro conditions
Pre-eclampsia is a disease of the...
placenta, once removed the pre-eclampsia goes away....treatment is delivery of baby and placenta
seizure prophylaxis meds
normal is 55%, can drop down to below 45%
ABG O2 should be what in 3rd trimester?
ABG O2 of pregnant woman in 3rd trimester should be at least 100 but could be up to 108
normal ABG values during pregnancy
pH:7.45-7.53 from resting hyperventilation
a pulse ox of 90% indicates...
P02 of 60
Po2 of 40
is d-dimer a good test for PE i pregnancy?
no, levels will be increased regardless
tx of bronchial asthma
what if pt have a VP shunt?
in 3rd trimester, increased abdominal pressure results in cessation of drainage and increased ICP
what do you think of if there is abdominal pain in the 3rd trimester
abruption of placenta or appendicits
MC general surgical problem during pregnancy
appendicits, may have pain in RLQ or RUQ
what % of blood volume can be lost before symptoms occur?
15% blood loss shows no significant symtoms
supine hypotensive syndrome
Fetus weight causes pressure on inferior vena cava/aorta causes hypotension, lift pt on right side up....pt should always be evaluated on her left side (right hip elevated)
what test should you quickly do on a pregnant pt that comes into the ER?
finger stick for hypoglycemia
alkalotic pH of vagina may indicate
MCC of trauma during pregnancy