Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB Test 3 > Chapter 27 > Flashcards

Chapter 27 Flashcards

1
Q

Hypertensive disorders

A

Gestational hypertension
Preeclampsia (only cure deliver baby)
Eclampsia (only cure deliver baby)
Chronic hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Common medical complication of pregnancy

A
  • Complicates 5% to 10% of all pregnancies

- Rate of pregnancy-related hypertension has risen steadily since 1990 for all ages and ethnic groups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

hypertensive disorders are a major cause of

A

prenatal death and IUGR (interuterine growth retardation)

10-15% of death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

predisposing factors

A
  • Family history
  • Primagravida
  • Pre-existing abnormality of vascular, metabolic or endocrine systems
  • Hypertension
  • Molar pregnancy- don’t have viable fetus (false pregnancy)
  • Twins - more Hcg
  • renal disease/renal problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Morbidity

A
  • Placental abruption (not during 3rd stage of labor)
  • Cerebral hemorrhage
  • Hepatic or renal dysfunction
  • DIC (diminished intrmuscular cognation
  • Pulmonary edema
  • Seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mortality

A

Pregnancy-related hypertension accounts for 10% to 15% of maternal deaths worldwide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Gestational hypertension

A

Onset of hypertension without proteinuria after week 20 of pregnancy
Systolic BP >140, diastolic BP >90 (have to have two different readings two different days)
-bp will return to normal 6 wks after delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Preeclampsia

A

Pregnancy-specific syndrome in which hypertension develops after 20 weeks of gestation in a previously normotensive woman
-move from preeclampsa to eclampsia when pt has a seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Eclampsia

A
  • Onset of seizure activity or coma in a woman with preeclampsia
  • No history of preexisting pathology
  • 70% of eclamptic women develop the condition while pregnant
  • 30% develop eclampsia in the immediate postpartum period (can still have seizure in postpartum period especially 1st 48 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

chronic hypertension

A

Hypertension present before pregnancy or diagnosed before week 20 of gestation and persists after 6 weeks postpartum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Chronic hypertension with superimposed preeclampsia

A

Women with chronic hypertension may acquire preeclampsia or eclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Preeclampsia etiology

A

A condition unique to human pregnancy

Signs and symptoms develop during pregnancy and disappear after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Preeclampsia Common risk factors:

A
  • Primigravidity or new partner in this pregnancy
  • Extremes of maternal age 35
  • Multifetal pregnancy
  • Obesity
  • Preexisting medical condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Preeclampsia pathophysiology

A
  • Current thought: poor perfusion and endothelial cell dysfunction
  • Arteriolar vasospasm diminishes diameter of blood vessels, which impedes blood flow to all organs and increases BP
  • Main pathogenic factor is vasospasm and reduced plasma volume
  • Decreased placental perfusion contributes significantly to restriction of fetal growth (less plasma volume so part of intrauterine growth retardation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Vascular Damage patho

A

Platelet aggregation
Fibrin deposits
Hemolysis of RBC’s
Decreased placental blood flow & IUGR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hypertension patho

A

Decreased vascular vol. & increased extravascular vol
Obstructed blood flow to liver & kidneys
Cerebral ischemia & CNS irritability.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

HELLP syndrome

A

-Laboratory diagnosis for a variant of severe preeclampsia that involves hepatic dysfunction: Hemolysis (H), Elevated liver, enzymes (EL)
Low platelets (LP)
-Diagnosis associated with increased risk for adverse perinatal outcomes
-Usually develops in third trimester or within 48 hours of birth

18
Q

Evaluating HELLP is important so

A

that early and aggressive therapy is initiated to prevent maternal and neonatal mortality

19
Q

Identifying and preventing preeclampsia

A

No reliable test or screening tool has been developed

20
Q

Health assessment

A

Dependent edema
Pitting edema
Deep tendon reflexes (DTRs)

21
Q

Mild gestational hypertension and mild preeclampsia Care Management

A 
Goals of therapy are to ensure maternal safety and deliver a healthy newborn close to term
Home care
Maternal and fetal assessment
Activity restriction
Diet
22
Q

Home Care for Mild Preeclampsia

A

Activity restrictions
Monitoring of fetal activity (kick counts)
Blood pressure monitoring (2-3 times a day)
Weight measurement (bc of edema)
Urinalysis for protein (1st void)
Diet without added salt
Fetal surveillance

23
Q

Severe gestational hypertension and severe preeclampsia Care Management

A

Goals of care are to ensure maternal safety and formulate a plan for delivery
Intrapartum care

24
Q

Severe gestational hypertension and severe preeclampsia - Intrapartum care -

A

Bed rest with side rails up
Darkened environment
Magnesium sulfate therapy
Antihypertensive medications

25
Q

Severe gestational hypertension and severe preeclampsia - postpartum care -

A

Vital signs, DTRs, level of consciousness
30% of cases of eclampsia and HELLP syndrome occur postpartum
Unable to tolerate excessive blood loss

26
Q

Severe gestational hypertension and severe preeclampsia - future health care -

A

Seven-fold risk of developing preeclampsia or eclampsia in a future pregnancy
Increased risk of adverse perinatal outcomes

27
Q

Eclampsia-SeizuresPreventive measures

A 
Provide quiet private room and closed door
Minimize lights and noise
Group assessments and care together
Avoid startling disruptions
Restrict visitors
28
Q

Eclampsia-Seizures watch for:

A

Premonitory signs: persistent headache and blurred vision
Epigastric or right upper quadrant pain
Altered mental status
Convulsions appearing without warning

29
Q

Protecting the woman and fetus (interventions for seizures)

A
  • Remain with the woman
  • During the clonic phase, turn the woman on her side– give MgSO4 IV push
  • Ensure a patent airway
  • Note the time and sequence of the convulsion
  • After the seizure, insert an airway
  • Suction woman’s mouth and nose
  • Administer oxygen
  • Observe fetal monitor patterns for signs of hypoxia
30
Q

Chronic hypertension affects

A

4% to 5% of pregnant women

31
Q

chronic hypertension Associated with increased incidence of:

A

Abruptio placentae
Superimposed preeclampsia
Increased perinatal mortality (IUGR, Preterm birth)

32
Q

Chronic hypertension Postpartum complications include:

A

Pulmonary edema
Renal failure
Heart failure
Encephalopathy

33
Q

Chronic hypertension

A
  • Def: hypertension precedes pg, or before the 20th week of pg or continues after the postpartum period (i.e. 6 weeks after delivery)
  • More common in older women, with obesity, DM, Black women
  • More likely to develop preeclampsia
  • Management: high protein diet, weigh q3 days, antihypertensive meds
34
Q

Hypertensive disorders during pregnancy are a leading cause

A

of worldwide infant and maternal morbidity and mortality

35
Q

Cause of preeclampsia is

A

unknown, and there are no known reliable tests for predicting which women are at risk for preeclampsia

36
Q

Preeclampsia is a

A

multisystem disease rather than an increase in BP only

37
Q

HELLP syndrome can occur

A

in women with severe preeclampsia and is considered life threatening

38
Q

Once preeclampsia becomes clinically evident therapeutic interventions

A

may slow progression of the disease, allowing the pregnancy to continue

39
Q

Magnesium sulfate, the anticonvulsive agent of choice for

A

preventing eclampsia, requires careful monitoring of reflexes, respirations, and urinary output
-Antidote, calcium gluconate, should be available at bedside

40
Q

Nursing actions during a convulsion:

A

ensuring a patent airway and client safety

41
Q

Chronic hypertension in pregnancy associated

A

with abruptio placenta and superimposed preeclampsia, fetal growth restrictions, and increased perinatal mortality

42
Q

Women with preeclampsia have an increased risk of

A

adverse perinatal outcomes in a future pregnancy

OB Test 3 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions