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special pops final > hypertension in pregnancy > Flashcards

hypertension in pregnancy Flashcards

1
Q

what is hypertension defined as?

A

> /= 140/90 on at least 2 readings at least 4-6 hours apart

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2
Q

what is the number one risk of maternal and fetal morbidity and mortality?

A

hypertension

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3
Q

gestational htn and preeclampsia have a higher risk of what later in life?

A

heart disease

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4
Q

what is a risk factor for future cardiovascular and metabolic disorders in mothers?

A

preeclampsia

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5
Q

what are 5 high risk factors for preeclampsia?

A
  1. chronic htn
  2. ckd
  3. htn in previous pregnancy
  4. dm (1 and 2)
  5. autoimmune diseases
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6
Q

what are 5 moderate risk factors to preeclampsia?

A
  1. age >40
  2. first pregnancy
  3. multi-gestational pregnancy
  4. bmi >35
  5. family history of preeclampsia
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7
Q

what is the presentation of preeclampsia?

A

typically asymptomatic

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8
Q

what are 2 standard screenings for preeclampsia?

A
  1. BP screen
  2. Urinalysis standard
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9
Q

what are 5 “hidden” signs of preeclampsia?

A
  1. headache
  2. change in vision
  3. rapid weight gain
  4. edema
  5. abdominal pain
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10
Q

what is the only true cure of preeclampsia?

A

delivery

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11
Q

what are the 2 diagnostic criteria of preeclampsia?

A
  1. blood pressure
  2. proteinuria
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12
Q

what is diagnostic for proteinuria in preeclampsia?

A

> /= 300 mg per 24 hour urine collection

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13
Q

what is not a diagnostic tool for proteinuria in preeclampsia?

A

dip stick reading of 1+

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14
Q

when may delivery be indicated in a patient with preeclampsia?

A

if preeclampsia is uncontrolled for 24-48 hours

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15
Q

what are 6 severe preeclampsia symptoms?

A
  1. htn (>160 systolic, >110 diastolic)
  2. thrombocytopenia
  3. impaired liver function
  4. renal insufficiency
  5. pulmonary edema
  6. visual disturbance
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16
Q

what are 2 things that are used for prevention of preeclampsia?

A
  1. aspirin or LMWH
  2. calcium
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17
Q

what are 4 non pharm treatments for htn and preeclampsia?

A
  1. modified bed rest
  2. sodium restriction
  3. frequent fetal monitoring
  4. daily bp monitoring
18
Q

when is treatment for htn recommended?

A
  1. chronic htn with persistent readings over 160/105
  2. severe htn with readings over 160/100 mmhg
19
Q

what are 3 medications that acn be used to treat the htn?

A
  1. methyldopa
  2. nifedipine
  3. labetolol
20
Q

what drug used for htn is an alpha 2 agonist?

A

methyldopa

21
Q

what are the starting doses for nifedipine?

A

30-60 mg once or twice daily

22
Q

what drug used for htn is a alpha/beta blocker

A

labetolol

23
Q

what is the doc to treat the htn?

A

labetolol

24
Q

when should you avoid the use of labetolol?

A

in pts with copd and asthma

25
Q

what are 3 SE seen with nifedipine?

A
  1. flushing
  2. headache
  3. edema
26
Q

what are 4 treatments that are not recommended?

A
  1. hydralazine
  2. ACEi/ARBs
  3. metoprolol/atenolol
  4. diuretics
27
Q

why is hydralazine not recommended?

A

fetal heart abnormailities

28
Q

why are ACEi/ARBs not recommended?

A

they are fetotoxic

29
Q

why are diuretics not recommended?

A

affects uterine blood flow

30
Q

why is metoprolol/atenolol not recommended?

A

risk of intrauterine growth restriction

31
Q

what is eclampsia?

A

preeclampsia with seizures

32
Q

when is eclampsia the most common?

A

in the 3rd trimester or within 48 hours of delivery

33
Q

what is used for eclampsia prophylaxis?

A

magnesium sulfate

34
Q

what are 4 ADRs that are seen with magnesium sulfate?

A
  1. confusion
  2. somnolence
  3. respiratory depression
  4. cardiac arrest
35
Q

what is considered a premature delivery?

A

birth prior to 36.6 weeks

36
Q

what is considered full term?

A

40 weeks or 37 if possible

37
Q

what are 2 treatments for premature prophylaxis?

A
  1. betamethasone
  2. dexamethasone
38
Q

when can you give premature prophylaxis?

A

gestational age 24-34 weeks and at risk of delivering within 7 days

39
Q

when is treatment for BP after delivery recommended?

A

> 150/110 mmHg

40
Q

if hydralazine or thiazides were given prior to birth what should be done?

A

a CBC in neonate because of reported cases of thrombocytopenia

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