Hypertensive Disorder Flashcards
Different Classifications
1.) Chronic Hypertension
2.) Gestational Hypertension
3.) Preeclampsia (PIH)
4.) Chronic hypertension with superimposed pre eclampsia
5.) Eclampsia
Transient hypertension of pregnancy. Development of HPN after 20 weeks of pregnancy in a previously normotensive woman without proteinuria
Gestational Hypertension
Development of HPN and proteinuria in a previously normotensive woman after 20 weeks of gestation or in the early postpartum period. Also termed PIH
Preeclampsia
Development of seizure or coma not attributed to other causes in a preeclamptic woman
Eclampsia
Hypertension in a pregnant woman present
before pregnancy
Chronic Hypertension
Chronic hypertension in association with preeclampsia
Chronic HPN with superimposed preeclampsia
Risk factors
1.) Multiple Pregnancies
2.) Primiparas <20 years of age or older than 40
3.) Women from low socioeconomic backgrounds
4.) Multigravida
5.) Hydramnios
6.) Pre existing HPN
Possible acute complications of hypertensive pregnancy:
Cardiovascular
1.) Hypertension
2.) Pulmonary Edema
3.) Reduced Cardiac Output
Possible acute complications of hypertensive pregnancy:
Renal
1.) Reduced glomerular filtration rate
2.) Proteinuria
3.) Cortical Necrosis
Possible acute complications of hypertensive pregnancy:
Hepatic
1.)Elevated Liver Enzymes
2.)Hepatic Dysfunction
3.)Subcapsular Bleeding
4.)Hepatic Rupture
Possible acute complications of hypertensive pregnancy
Central nervous system
1.)Cerebral hemorrhage
2.)H e a d a c h e / b l u r r e d vision
3.)Scotoma
4.)Cortical Blindness
5.)Posterior Reversible Encephalopathy
Syndrome (PRES)
6.)Seizure
Laboratory and Diagnostics
1.) 24 urine specimen collection
2.) Random urine dipstick evaluation
3.) BP taking and recording
4.) Weight monitoring
Management with severe PIH:
1.) If the pregnancy is greater than 37 weeks, labor can be _____or_____ can be preformed to end pregnancy
2.) If the pregnancy is less than 37 weeks interventions will be initiated to allow the fetus come to _____
3.) If symptoms persist or worsen or fetal testing shows compromised fetus, _______ or __ is necessary even if the pregnancy is preterm
1.) Induced or CS
2.) Term
3.) Vaginal delivery or CS
Management for severe PIH part2
1.) Promote bed rest
2.) Monitor fetal and maternal well being
3.) Promote good nutrition
4.) Administer medications to prevent eclampsia
~Hydralazine (apresoline) or labetalol (Normodyne)
Management for Tonic-clonic seizure (ECLAMPSIA)
TONIC
1.) maintain patent airway
2.) No tongue depressors
3.) O2 supplement
4.) side lying position
Management for Tonic-clonic seizure (ECLAMPSIA)
CLONIC
1.) o2 supplement
2.) Diazespam or magnesium sulfate
Postical - semicomatose
1.) Cannot be aroused except by painful stimuli for 1 to 4 hours
2.) Side lying
3.) NPO
4.) Close monitoring
5.) Check Vaginal bleeding q15mins
Hypotensive drugs - lowers BP
1.) Hydralazine (Apresoline)
2.) labetalol (Normodyne)
3.) Magnesium Sulfate
Hypotensive drugs - lowers BP
1.) Hydralazine (Apresoline)
2.) labetalol (Normodyne)
3.) Magnesium Sulfate
Drug of choice
• A cathartic, reduces edema by causing shift
in fluid from the extracellular spaces into
the intestine.
• A central nervous system depressant action
(it blocks peripheral neuromuscular
transmissions) which lessens the possibility
of seizures
Magnesium Sulfate
MAGNESIUM SULFATE:
1.) Infuse loading dose slowly over __-__ mins 10gms or deep IM, 5mgs / buttocks
2.) IV drip of __gm/hr
3.) Administer a ________ in fusion
1.) 15 to 30
2.) 1
3.) Piggy back
MAGNESIUM TOXICITY:
• Decreased urine output
• Depressed respirations
• Reduced consciousness
• Decreased deep tendon reflexes
- patellar reflex (knee jerk).
Long term effect – osteoporosis
Magnesium Toxicity antidote
10ml of 10% Calcium gluconate
