Pre eclampsia Flashcards
develops after 20 weeks of gestation
without proteinuria or organ dysfunction
resolves within 12 weeks postpartum
140/90 on two separate occasion at least 4 hours apart
Pregnancy induced hypertension or gestational hypertension
pre eclampsia
- develops after 20 weeks of gestation
- with >300 mg/24 hour urine 3.proteinuria or organ dysfunction
- protein creatinine ratio >0.3
- serum creatinine >1.1 mg/dl
- Elevated liver enzyme
- pulmonary edema
- neurological symptoms
severe preeclampsia / preeclampsia with severe features
> 160/110 mmhg
severe organ dysfunction (ex.hellp syndrome)
extreme edema
proteinuria 4+ or 3+
oliguria
cerebral or visual disturbances
thrombocytopenia
epigastric pain
hepatic dysfunction
maternal complications of pre eclampsia
stroke
heart failure
liver/kidney failure
Hellp syndrome
fetal risk of pre eclampsia
pre term birth
intrauterine growth restriction
stillbirth
placental abruption
most severe form of preeclampsia
tonic clonic seizures
may occur before,during or after delivery
eclampsia
maternal complications of eclampsia
stroke
coma
cerebral hemorrhage
aspiration pneumonia
organ failure
death
fetal complications of eclampsia
hypoxia
stillbirth
preterm birth
fetal distress
management for eclampsia
magnesium sulfate
blood pressure control (labetalol & hydralazine)
immediate delivery if severe
3 key players for pre eclampsia
- spiral arteries
- placenta
- endothelial cells
pih & gh management
lifestyle modification
- rest and activity regulation
- sodium restriction
3.hydration & diet - avoid caffeine & alcohol
edema develops because of
protein loss
sodium retention
lowered glomerular filtration rate
weight gain more than 2lb/week in second trimester or 1lb/week in third trimester indicates
abnormal tissue fluid retention
nursing intervention for preeclampsia mild cases
- monitor anti platelet therapy
- promote bed rest and left lateral positioning
- monitor blood pressure and urinary protein levels
4.encourage a balanced diet
5.provide emotional and psychological support
first symptom a woman notices
edema
nursing intervention for preeclampsia with severe
implement strict bed rest
monitor maternal and fetal well being
administer antihypertensive medications
administer magnesium sulfate
maintain iv access
monitor fluid balance
nursing intervention for eclampsia
ensure airway patency during seizure
administer emergency medications
provide oxygen support
monitor fetal well being
postictal stage care
prepare for urgent delivery
twitching or jerking
clonic
stiffening
tonic
administration of magnesium sulfate
piggyback infusion
drug used in pre and eclampsia
diazepam
calcium gluconate
magnesium sulfate
hydralazine
causes of magnesium sulfate toxicity
- excessive iv infusion
2.renal impairment
3.dosage miscalculation
magnesium sulfate toxicity
bp decrease
urine output decrease
respiratory rate decrease
patellar reflex absent
Hellp syndrome
Hemolysis, Elevated liver enzymes, Low platelet level
Hellp syndrome major complications
1.seizures
2.stroke
3.liver rupture
4.placental abruption
mild clonus movement
2 movement
moderate clonus movement
3 or 4 movements
severe clonus movement
over 6 movements
no response; hypoactive;abnormal
0
somewhat diminished response but not abnormal
1+
average response
2+
brisker than average but not abnormal
3+
hyperactive; very brisk; abnormal
4+
preeclampsia is classified as
1.preeclampsia without severe features
2.preeclampsia withsevere features
3.eclampsia
pih & gh management
no drug therapy is necessary
continued laboratory testing of urine and blood
bedrest
fetal monitoring:
fetal movement counting
nonstress test
biophysical testing
doppler flow studies
