hypertension in pregnancy Flashcards
gestational hypertension
hypertension w/o proteinuria that occurs after 20 weeks
preeclampsia
multisystem disease process characterized by hypertension and proteinuria occurring after 20 weeks gestation
eclampsia
seizure activity in patient w/ preeclampsia
chronic hypertension
hypertension prior to pregnancy or diagnosed prior to 20 weeks gestation
chronic hypertension w/ superimposed preeclampsia
chronic hypertension with proteinuria or a worsening of hypertension; occurs after 20 weeks gestation
preeclampsia risk factors
-1st pregnancy
-pregnant woman’s age
-multiple gestation
-black
-diabetes
-obesity
-renal disease
-immunologic disorders
-pre-existing hypertension
-hx of preeclampsia
-IVF
Severe preeclampsia complication
HELLP syndrome
HELLP syndrome
Hemolysis
Elevated Liver enzymes
Low Platelets
additional complications for pregnancy person with severe preeclampsia
-pulmonary edema
-renal failure
-cardiac failure
-DIC
death
additional complications for fetus with severe preeclampsia
-prematurity
-IUGR
-hypoxia
-acidosis
-placenta abruption
-death
preeclampsia without severe features
-BP >140 an/or 90 x2
-proteinuria > 300mg/24 hours or +1, +2 urine dipstick
-reflexes normal
-asymptomatic
-lab values unchanged
-no IGUR
-normal urinary output
preeclampsia with severe features
-BP >160 and/or 110 x2
-proteinuria >5g/24 hours or +3, +4 urine dipstick
-hyperreflexia
-persistent headache, blurred vision, blind spots, epigastric pain
-increased creatinine, uric acid, BUN, liver enzymes, decreased platelets
-IUGR
-oliguria
cure for preeclampsia
delivery
treatment of preeclampsia without severe features
-can be home care or inpatient
-rest
-BP
-daily weight (edema)
-daily protein dipstick
-diet
-reflexes
-lab testing
-fetal well-being
-assess s/sx of worsening
treatment of preeclampsia with severe features
-hospitalization is necessary
-expectant vs. expeditious
care of patient with preeclampsia with severe features in labor
-administer mag sulfate
-administer antihypertensives (hydrazine, labetalol, nifedipine)
-provide calm, quiet environment
-best rest w/ side-lying position
-analgesia
-IV hydration
-Pitocin
actions during seizure
-lower the patient’s head & turn on side
-suction
-do not restrain
-time, length, type
-call for help, notify provider
actions after seizure
-O2
-auscultate lungs
-assess fetal heart rate, labor activity, s/s of abruption
-avoid stimulation
postpartum care
-continue to monitor for at least 24 hours
-continue to administer mag sulfate for 24 hours
-routine postpartum assessments
-INCREASED RISK FOR UTERINE ATONY (b/c mag sulfate)
-risk factor for CV disease
