memorize for Module 3 Flashcards
Symptoms to help distinguish from Gestational hypertension and preeclampsia
Headache
visual disturbances
epigastric or right upper quadrant pain
family dx of preeclampsia
Protein is absent finding in how many women with preeclampsia
15-25%
What other testing has found to correlate to 24 hours urine for accurate proteinuria
timed urine collection of 2, 4, and 12 hours
Protein/creatinine ratio
How many BP needed to diagnose a pregnant woman with HTN
2 > 140/90 4 hours apart
What percentage of women may not have elevated BP with preeclampsia
10-15%
What labs are drawn to diagnose a woman with preeclampsia
H/H
AST/ALT
Platelets
LDH
Serum Creatinine
Urine protein/creatinine ratio
Normal range for AST
2nd trimester 3-33 U/L
3rd trimester 4-32 U/L
Normal range for ALT
2nd trimester 2-33 U/L
3rd trimester 2-25 U/L
Platelets
2nd trimester 155-409,000
3rd trimester 146-429, 000
LDH
2nd trimester 80-447 U/L
3rd trimester 82-524 U/L
Serum Creatinine
0.4-0.8 mg/dL
Urine Protein/creatinine ratio
<0.3 mg/dL
what does WHNP do with Patient with preeclampsia without severe features
collaborate with physician
Signs of preeclampsia
right upper quadrant pain that does not resolve
feeling nauseous; throwing up
swelling in hands and face
headache
seeing spots
gaining more than 5 lbs in 1 week
Management plan for patient’s with preeclampsia without severe features
Biweekly office visits
Evaluate BP and signs and sx of preeclampsia
fundal height
weight gain
fetal surveillance testing
weekly labs
What does fetal testing in a pregnant woman include
NST with AFI or BPP biweekly
what percentage of women has research shown that headache precedes preeclampsia
50-75%
what percentage of women has research shown that visual changes precedes preeclampsia
20-30%
A hereditary connection for preeclampsia has been found with an increased risk for preeclamptic mothers, sisters, twins
Mother: 20-40%
Sisters 11-37%
twins 22-47%
Correct way to take blood pressured
obtaining a correct size cuff: width of bladder 40% of circumference and encircles 80% of arm
proteinuria for preeclampsia
protein urine equal to or > 300 mg in a 24 hour urine
Patients high risk for preeclampsia
History of preeclampsia, especially when accompanied by an adverse outcome
Multifetal gestation
chronic hypertension
type 1 or 2 diabetes
renal disease
autoimmune disease
patient moderate risk for preeclampsia
nulliparity
obesity BMI> 30
family his of preeclampsia (Mother/sister)
sociodemographic characteristics
African American race
low socioeconomic status
Age 35 or older
Personal history factors
low birth weight or small for gestational age
Previous adverse pregnancy outcome
more than 10 year pregnancy interval
When are antihypertensive recommended for the management of gestational hypertension or preeclampsia
160/110 and greater
Prenatal clients with asthma are at risk for which of the following conditions
Fetal growth restriction
preeclampsia
Preterm birth
Classification of intermittent asthma (well controlled)
Symptoms frequency
nighttime awakening
interference with normal activity
FEV, or Peak Flow
Symptoms Frequency= 2 days per week or less
Nighttime awakening = twice per month or less
interference with normal activity= none
FEV, or Peak Flow = more than 80%
Classification of mild persistent ( not well controlled)
Symptoms frequency
nighttime awakening
interference with normal activity
FEV, or Peak Flow
Symptoms Frequency= more than 2 days per week
Nighttime awakening = more than once per month
interference with normal activity= minor limitation
FEV, or Peak Flow = more than 80%
Classification of moderate persistent asthma (well controlled)
Symptoms frequency
nighttime awakening
interference with normal activity
FEV, or Peak Flow
Symptoms Frequency= Daily symptoms
Nighttime awakening = more than once per week
interference with normal activity= some limitation
FEV, or Peak Flow =60-80%
Classification of severe persistent asthma (well controlled)
Symptoms frequency
nighttime awakening
interference with normal activity
FEV, or Peak Flow
Symptoms Frequency= throughout the day
Nighttime awakening = four times per week or more
interference with normal activity=extremely limited
FEV, or Peak Flow = less then 60%
Classification of symptoms frequency in Asthma
intermittent = 2 days per week or less
Mild = more than 2 days per week
Moderate = daily symptoms
Severe = throughout the day
Classification of nighttime awakening in Asthma
intermittent = twice per month or less
mild = more than twice per month
moderate = more than once per week
severe = four times per week or more
Classification of interference with normal activity for Asthma
intermittent = none
mild = minor limitation
moderate = some limitation
severe = extremely limitation
Classification of FEV or Peak Flow of Asthma
intermittent = more than 80%
mild = more than 80%
moderate = 60-80%
Severe = le4ss then 60%
Treatment for Asthma
Mild Intermittent = Short acting B-agonist for symptoms (albuterol)
Mild persistent = short acting B-agonist + Low dose inhaled corticosteroid
Moderate persistent = short acting B agonist + low dose ICS + LABA (long acting beta agonist
Severe persistent = short acting b agonist + High-dose ICS + LABA
Very severe persistent = short acting b agonist + high dose ICS + LABA + oral corticosteroids
Treatment for Asthma
short acting B agonist = albuterol
low dose inhaled corticosteroid = Pulmicort
long acting b agonist = Symbicort
What is VIRCHow’s triad
VI = Vascular injury
R = Reduced Blood flow (Venous stasis)
HC = Hypercoagulability
