Hypertension in Pregnancy

Question 1

What is the most common medical complication reported during pregnancy?

Answer 1

Hypertension.

Question 2

Which race is more likely to die of preeclampsia?

Answer 2

African american.

Question 3

What is the definition of hypertension in pregnant women?

Answer 3

Diastolic over 15mmHg normal baseline
Systolic over 30mmHg normal baseline
Over 140/90

Question 4

How is chronic hypertension classified during pregnancy?

Answer 4

Hypertension that predates the pregnancy or lasts 42 days postpartum.

Question 5

What is pregnancy induced hypertension (PIH)?

Answer 5

Onset of hypertension during pregnancy after 20 weeks or in the first 24 hours after birth with or without symptoms of hypertension during pregnancy

Question 6

When is chronic hypertension present?

Answer 6

Before the pregnancy or before week 20 of pregnancy

Question 7

What is chronic hypertension with superimposed preeclampsia?

Answer 7

Women who have chronic hypertension may aquire preeclampsia or exlampsia.

Question 8

What is transient hypertension?

Answer 8

Gestational hypertension with no signs of preclampsia and present at the time of birth; resolves after 12 weeks.

Question 9

What is preeclampsia?

Answer 9

Pregnancy specific syndrome that occurs 20 weeks after gestation with gestational HTN and proteinuria.

Question 10

What is eclampsia?

Answer 10

The occurense of seizures in a woman with preeclampsia that is not attributed to anything else.

Question 11

Can PIH turn into preeclampsia?

Answer 11

Yes

Question 12

What is the main difference between PIH and preeclampsia?

Answer 12

There is protein in the urine in preeclampsia-

Question 13

What are blood pressure readings for severe preeclampsia?

Answer 13

Over 160/110

Question 14

What is exlampsia?

Answer 14

Seizure activity or coma in women with preeclampsia.

Question 15

What type of seizure happens during Eclampsia and why?

Answer 15

Grand Mal- there is no perfusion to the brain because of vasospasms.

Question 16

What can happen to the mother and fetus if eclampsia is not treated?

Answer 16

Cerebral hemorrhage, fetus can be hypoxic, placental abruption, and death.

Question 17

What are some causes of pre/eclampsia?

Answer 17

Heredity, physiological, psychological, nutritional excess or decifiencies, endocrine, sometimes unknown.

Question 18

What are some risk factors women may have to develop preeclampsia?

Answer 18

Primigravidity, multifetal pregnancy, obesity, before age 19, after age 40.

Question 19

What is the patho of preeclampsia?

Answer 19

Arteriolar vasospasms that diminish the diameter of blood vessels, with decreases blood flow to organs and increases BP.

Question 20

What organs can be depressed from preeclampsia?

Answer 20

Placenta, kidneys, liver, and brain.

Question 21

What are some risk factors for PIH?

Answer 21

HTN history, diabetes, multiple pregnancies, nutrition, family history, pverty, age

Question 22

What does generalized arterial vasoconstriction lead to?

Answer 22

Poor renal perfusion, decreased utero placental perfusion, damaged vascular walls, increased platelets, seizures, dehydration

Question 23

What is the “classic triad” of preeclampsia?

Answer 23

Hypertension, edema, and proteinuria.

Question 24

Where is edema usually seen in pregnant women?

Answer 24

Above the waist- fingers, face, extremities

Question 25

What is proteinuria?

Answer 25

protein in the urine- usually a late sign

Question 26

What are some other signs of preclampsia?

Answer 26

Headaches, visual disturbances, right upper quadrant pain (epigastric), n/v, oliguria, hyper reflexia, irritability, cyanosis, pulmonary edema.

Question 27

What are some care techniques for seizures?

Answer 27

Keep the patient safe, keep bed rails up, record when it starts, stops, and what happened, use O2, stay with pt, check baby.

Question 28

What is HELLP syndrome?

Answer 28

Hemolysis, Elevated Liver enzymes, Low Platelets.

Question 29

What are some symptoms of HELLP?

Answer 29

BP of 160/110. +3 proteinuria, <100k platelets, decreased urine output, visual disturbances.

Question 30

What is HELLP syndrome associated with?

Answer 30

Placental abruption, renal failure, pulmonary edema, ruptured liver hematoma

Question 31

What should the nurse assess for preeclampsia?

Answer 31

Interview for HX, PE, Dependent edema, reflexes, Lab tests

Question 32

What is the prevention for PIH?

Answer 32

Prenatal care, teaching, high protein, low sodium diet, vitamins, low dose aspirin as rx

Question 33

What is the treatment of preeclampsia?

Answer 33

Home care, nurse should assess home environment, modified bed rest, vital signs

Question 34

What is the treatment for severe preeclampsia?

Answer 34

Daily weights, urine dipstick, strict i & o, fetal activity, increase fluids, homans sign, seizure precaution.

Question 35

How should the fetus be assessed?

Answer 35

FHR, activity, non stress test, stress test, estriol testing

Question 36

What is estriol testing?

Answer 36

checking for function of placenta

Question 37

What is magnesium sulfate given for?

Answer 37

anticonvulsant to be given for neuromuscular irritability and fetal neuro protection

Question 38

What are side effects of Magnesium sulfate?

Answer 38

flushing, sweating, depressed CNS, flaccid muscles, resp depression, fetal bradycardia, respiratory arrest

Question 39

What is ankle clonus?

Answer 39

Dorsiflexion of the foot three times in rapid succession and it should not move

Question 40

What does evidence show helps when magnesium sulfate is given 2 hours before delivery?

Answer 40

reduces risk for cerebral palsy

Question 41

What is labetalol?

Answer 41

a beta blocker that decreases the nerve response in the heart and decreases pulse and BP

Question 42

What is apresoline?

Answer 42

A vasodilator that increases cardiac output

Question 43

What is aldomet?

Answer 43

used for maintenance of hypertension

Question 44

What is procardia?

Answer 44

calcium channel blocker to decrease systemic vascular resistance