hypertension in pregnancy Flashcards

1
Q

gestational hypertension

A

hypertension w/o proteinuria that occurs after 20 weeks

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2
Q

preeclampsia

A

multisystem disease process characterized by hypertension and proteinuria occurring after 20 weeks gestation

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3
Q

eclampsia

A

seizure activity in patient w/ preeclampsia

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4
Q

chronic hypertension

A

hypertension prior to pregnancy or diagnosed prior to 20 weeks gestation

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5
Q

chronic hypertension w/ superimposed preeclampsia

A

chronic hypertension with proteinuria or a worsening of hypertension; occurs after 20 weeks gestation

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6
Q

preeclampsia risk factors

A

-1st pregnancy
-pregnant woman’s age
-multiple gestation
-black
-diabetes
-obesity
-renal disease
-immunologic disorders
-pre-existing hypertension
-hx of preeclampsia
-IVF

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7
Q

Severe preeclampsia complication

A

HELLP syndrome

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8
Q

HELLP syndrome

A

Hemolysis
Elevated Liver enzymes
Low Platelets

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9
Q

additional complications for pregnancy person with severe preeclampsia

A

-pulmonary edema
-renal failure
-cardiac failure
-DIC
death

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10
Q

additional complications for fetus with severe preeclampsia

A

-prematurity
-IUGR
-hypoxia
-acidosis
-placenta abruption
-death

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11
Q

preeclampsia without severe features

A

-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

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12
Q

preeclampsia with severe features

A

-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

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13
Q

cure for preeclampsia

A

delivery

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14
Q

treatment of preeclampsia without severe features

A

-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

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15
Q

treatment of preeclampsia with severe features

A

-hospitalization is necessary
-expectant vs. expeditious

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16
Q

care of patient with preeclampsia with severe features in labor

A

-administer mag sulfate
-administer antihypertensives (hydrazine, labetalol, nifedipine)
-provide calm, quiet environment
-best rest w/ side-lying position
-analgesia
-IV hydration
-Pitocin

17
Q

actions during seizure

A

-lower the patient’s head & turn on side
-suction
-do not restrain
-time, length, type
-call for help, notify provider

18
Q

actions after seizure

A

-O2
-auscultate lungs
-assess fetal heart rate, labor activity, s/s of abruption
-avoid stimulation

19
Q

postpartum care

A

-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