HTN In Pregnancy

Question 1

What is BP levels of stage 1 and stage 2?

Answer 1

Systolic 130-139 diastolic 80-89

Systolic 140-149 diastolic 90-99

Question 2

What is the difference between chronic and gestational HTN?

Answer 2

Chronic is present before pregnancy or recognized in the first half of pregnancy
Gestational is recognized after 20 weeks

Question 3

What is preeclampsia and eclampsia?

Answer 3

After 20 weeks HTN, edema, and proteinuria

Preeclampsia with seizures

Question 4

What values are considered mild chronic HTN and severe chronic HTN?

Answer 4

Less than 160/110 and greater than 160/110

Question 5

3 symptoms of preeclampsia?

Answer 5

Vision problems, right upper quadrant pain, and headache

Question 6

What is going on in the brain, heart, and lungs during preeclampsia?

Answer 6

Cerebral edema
Lowered circulating blood volume
Non cardiac cause of pulmonary edema

Question 7

What is going on in with liver, kidneys, and eyes in preeclampsia?

Answer 7

Fibrin deposition
Glomerular caps swell and narrow
Edema in the eyes

Question 8

BP, level of proteinuria and symptoms of mild preeclampsia?

Answer 8

140/90 to 160/110
300 mg to 5 grams per day or .3 protein/creatine
No symptoms

Question 9

BP, proteinuria level, and symptoms of severe preeclampsia?

Answer 9

160/110 and over
Over 5 grams or 3+ protein on two tests 4 hours apart
Oliguria, cerebral/visual problems, pulmonary edema, right upper quadrant pain, elevated liver enzymes and thrombocytopenia

Question 10

3 things to do for treatment if patient has mild preeclampsia less than 37 weeks?

Answer 10

Bed rest, BPP or NST testing weekly, fetal growth US every few weeks

Question 11

What to do for treatment of mild preeclampsia 37 -40 weeks?

Answer 11

If cervix is good, induce

If cervix is not favorable, give ripening agent to induce

Question 12

4 things to do to treat severe preeclampsia?

Answer 12

Put in hospital
Deliver is greater than 34 weeks
BP meds
Corticosteroids if less than 37 weeks

Question 13

What is magnesium sulfate used for?

Answer 13

Seizure prophylaxis

Question 14

Therapeutic range for magnesium sulfate?

Answer 14

5-9

Question 15

What is the complication we need to be looking out for with preeclampsia and eclampsia?

Answer 15

HELLP syndrome

Question 16

Two things to to do with eclampsia?

Answer 16

Protect the airway and give magnesium sulfate as first line treatment

Question 17

3 physical exam findings for preeclampsia?

Answer 17

Brisk reflexes, clonus and edema

Question 18

What 3 hypertensives did she say to use to treat BP in pregnant women?

Answer 18

Labetalol
Hydalzine
Nifedipine

Question 19

7 risk factors for preeclampsia?

Answer 19

Less than 20 and older than 35
Diabetes
Multiple gestation
Chronic HTN
Renal disease
Prior history of preeclampsia 
Thyroid disease