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Mgmt Test 2 - OB > hypertensive disorders in pregnancy > Flashcards

hypertensive disorders in pregnancy Flashcards

1
Q

types of hypertensive disorders in preg

A

gestational hypertension - hypertension w/o proteinuria
pre-eclampsia - multisystem disease process characterized by hypertension and proteinuria
emclampsia - seizure activity in woman w/pre eclampsia

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2
Q

complications fo severe preeclampsia

A

HELLP syndrome

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3
Q

HELLP SYNDROME (severe preeclampsia)

A

Hemolysis - decreased hemoglobin
Elevated Liver enzymes - increased AST, LDH, ALT
Low Platelets - decreased platelets

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4
Q

hypertensive disorders of pregnancy

A

chronic hypertension - htn prior to preg or dx prior to 20weeks
chronic hypertension w/superimposed preeclampsia - chronic htn w/proteinuria or worsening htn; after 20wks

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5
Q

preeclampsia

A

incidence
etiology
prevention
progression

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6
Q

predisposing fxrs for preeclampsia

A 
1st preg/multigesetational
maternal age
African-american
diabetes
obesity
hx of htn or preeclampsia
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7
Q

physiology of preclampsia (stage 1)

A

inadequate placental formation

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8
Q

physiology of preclampsia (stage 2)

A

maternal syndrome

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9
Q

the only cure for preeclampsia

A

delivery

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10
Q

dx criteria mild preclampsia

A 
BP>=140 AND/OR 90X2
PROTEINURIA >=300MG/24HRS OR +1, +2 URINE DIP
ASYMPTOMATIC
NORM REFLEXES
LAB VALUES UNCHANGED
NO IUGR
NORMAL URINARY OUTPUT
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11
Q

dx criteria severe preeclampsia

A

BP>=160 AND/OR 110X2
PROTEINURIA >5g/24HRS. +3, +4 URINE DIP
HYPERREFLEXIA
PERSISTENT HEADACHE, BLURRED VISION, EPIGASTRIC PAIN
INCREASED CREAT, URIC ACID, BUN, LIVER ENZYMES, DECREASED PLATELETS
IUGR
OLIGURIA (NOT ENOUGH)

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12
Q

MILD PREECLAMPSIA CARE

A

L&D FOR EVAL
home/hospital care
rest
nurse/self assess: bp, diet, reflex, urine dip, labs, fetal movement, edema, s/s of worsening

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13
Q

SEVERE PREECLAMPSIA CARE

A

REQ’D HOSPITAL STAY
PSYCHOSOCIAL SUPPORT
EDUCATE
EXPECTED/EXPEDITIOUS DELIVERY

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14
Q

Care of pt w/severe preeclampsia in labor

A 
mag sulfate
anti-hypertensives (hydralazine, labetalol)
calm & quiet
bedrest/side lying
hydration
pitocin
analgesia
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15
Q

care of pt receiving mag sulfate

A

assess - resp., reflex, urine output (hourly)

BP, FHR, protein, labs (serum mag)

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16
Q

trt mag toxicity with

A

calcium gluconate

17
Q

physician order

A 
VS q15
FHR monitoring (continuous)
18
Q

presence of seizures

A

signs of impending eclampsia

19
Q

actions during seizure

A 
dont restrain
lower head - turn to side
suction
time,length,type
call for help - notify MD
20
Q

action after seizure

A 
o2
auscultate lungs
assess FHR, s/s of abruption, labor activity
avoid stimulation
*DELIVER*
21
Q

Collaborative rx for seizure

A

mag sulf 4-6g IV

22
Q

nursing dx for htn disorders in preg

A

risk for fetal injury (placenta)
high risk seizure (decreased organ fxn)
knowledge deficit

Mgmt Test 2 - OB (14 decks)

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