HTN in pregnancy Flashcards

1
Q

Onset of hypertension without proteinuria or other systemic findings diagnostic for preeclampsia after week 20 of pregnancy
Systolic BP >140, diastolic BP >90

A

Gestational hypertension

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2
Q

Pregnancy-specific condition in which hypertension and proteinuria develop after 20 weeks of gestation in a previously normotensive woman

A

preeclampsia

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3
Q

In the absence of proteinuria, preeclampsia may be defined as hypertension along with the following:

A
Thrombocytopenia
Impaired liver function
New development of renal insufficiency
Pulmonary edema
New-onset cerebral or visual disturbances
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4
Q

Onset of seizure activity or coma in a woman with preeclampsia
No history of preexisting pathology

A

eclampsia

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5
Q

Women can develop eclampsia…

A

in the immediate postpartum period OR

50% of eclamptic women develop the condition while pregnant

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6
Q

Hypertension present before pregnancy or diagnosed before week 20 of gestation

A

chronic hypertension

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7
Q

Chronic hypertension with superimposed preeclampsia

A

Women with chronic hypertension may acquire preeclampsia or eclampsia
Can be difficult to diagnose

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8
Q

what is the cause of preeclampsia

A

unknown, many theories

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9
Q

Progressive disorder with placenta as the root cause

Begins to resolve after the placenta has been expelled

A

Preeclampsia

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10
Q

Vascular remodeling does not occur or only partially develops in women with preeclampsia leading to what

A

decreased placental perfusion and hypoxia result

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11
Q

what does placental ischemia lead to

A

endothelial cell dysfunction

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12
Q

what does generalized vasospasm

A

poor tissue perfusion in all organ systems
Increased peripheral resistance and blood pressure (BP)
Increased endothelial cell permeability

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13
Q

Laboratory diagnosis for a variant of severe preeclampsia that involves hepatic dysfunction

A

HELLP

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14
Q

breakdown the HELLP components

A

Hemolysis (H)
Elevated liver enzymes (EL)
Low platelets (LP)

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15
Q

HELLP syndrome occurs in

A

0.5% to 0.9% of all pregnancies.

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16
Q

Result of arteriolar vasospasm, endothelial cell dysfunction with fibrin deposits, and adherence of platelets in blood vessels

A

HELLP syndrome

17
Q

The clinical presentation is often nonspecific; most women with the disorder report the following:

A

History of malaise
Influenza-like symptoms
Epigastric or right upper quadrant abdominal pain
Symptoms worsen at night and improve during the daytime.

18
Q

Identifying and preventing preeclampsia

A

No reliable test or screening tool has been developed
Low-dose aspirin (60 to 80 mg) may help certain high risk women
Potential biomarkers being investigated
Tyrosine kinase (sFLt) and serum placental growth factor
Abnormal uterine artery Doppler velocimetry in the first or second trimester of pregnancy

19
Q

signs and symptoms of severe preeclampsia

A

Headaches
Epigastric pain
Right upper quadrant abdominal pain
Visual disturbances

20
Q

when is a proteinuria test done

A

ideally determined by evaluation of a 24-hour urine collection

21
Q

assessment and diagnosis of preeclampsia

A

Accurate measurement of BP
Assessment of edema, although the presence of edema is no longer included in the definition of preeclampsia
Deep tendon reflexes (DTRs)
Assess for hyperactive reflexes (clonus)
Proteinuria: ideally determined by evaluation of a 24-hour urine collection
Evaluate for signs and symptoms of severe preeclampsia:

22
Q

goals/interventions of Mild gestational hypertension and preeclampsia without severe features

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
23
Q

relaxes the CNS, and as a side effect it lower blood pressure

A

magnesium sulfate therapy

24
Q

goal of severe gestational hypertension and preeclampsia with severe features

A

to ensure maternal safety and formulate a plan for delivery.

25
Q

intrapartum care of severe gestational hypertension and preeclampsia with severe features

A

Bed rest with siderails up
Darkened environment
Magnesium sulfate therapy
Antihypertensive medications

26
Q

postpartum care of severe gestational hypertension and preeclampsia with severe features

A

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

27
Q

future health care of severe gestational hypertension and preeclampsia with severe features

A

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

28
Q

immediate care of eclampsia

A

Premonitory signs: persistent headache and blurred vision
Epigastric or right upper quadrant pain
Altered mental status
Convulsions appearing without warning
Ensuring a patent airway and client safety
Maternal stabilization