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Special Populations > Pregnancy and HTN > Flashcards

Pregnancy and HTN Flashcards

1
Q

What is the definition of gestational HTN?

A

> /= 140/90 mmHg on at least 2 separate readings at least 4-6 h apart

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2
Q

What does preeclampsia and HTN increase your risk for?

A
  1. risk factor of future CV and metabolic disorders
  2. preterm delivery
  3. stoke
  4. seizures
  5. death
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3
Q

What are high risk factors for gestational HTN?

A
  1. chronic HTN
  2. CKD
  3. HTN previous pregnancy
  4. DM (1 and 2)
  5. autoimmune diseases
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4
Q

What are the moderate risk factors for gestational HTN?

A
  1. age >40
  2. 1st preganacy
  3. multiples
  4. BMI>35
  5. family hx of preeclampsia
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5
Q

What are s/s of preeclampsia?

A
  1. usually asymptomatic
  2. headahce
  3. rapid weight gain
  4. change in vision
  5. abdominal pain
  6. edema
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6
Q

What is the dx criteria for preeclampsia?

A
  1. > /= 140/90 mmHg on at least 2 separate readings at least 4-6 h apart after 20 weeks
  2. > 160 or >110
    AND
    proteinuria >/=300 per 24h urine collection
    OR
    thrombocytopenia, renal insufficiency, impaired liver function
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7
Q

What is the treatment of uncontrolled severe preeclampsia?

A

delivery if uncontrolled after 24-48h

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8
Q

What is severe preeclampsia?

A

> 160/>110
thrombocytopenia
renal insufficiency
impaired liver function

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9
Q

What are treatments to prevent preeclampsia?

A
  1. aspirin (low dose) last trimester
  2. LMWH
  3. calcium (1g/day)
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10
Q

What are nonpharm tx for preeclampsia and gestational HTN?

A
  1. modified bed rest
  2. Na reduction
  3. daily BP monitoring
  4. fetal monitoring
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11
Q

What are pharm tx for preeclampsia and gestational HTN?

A
  1. Methyldopa
  2. Nifedipine ER
  3. Labetalol
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12
Q

When should pharm tx for preeclampsia and gestational HTN begin?

A
  1. BP > 160/110
  2. chronic/ persistent readings >160/105
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13
Q

What is dosing for Mehtydopa?

A

250mg 2-4 x daily, titrate as tolerated every 2 days

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14
Q

What are SEs with Methyldopa?

A
  1. somnolence
  2. depression
  3. orthostatic hypotension
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15
Q

What are SEs with Nifedipine ER?

A
  1. flushing
  2. headache
  3. peripheral edema
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16
Q

What patients should Labetolol not be used in?

A

asthma
COPD

17
Q

What are SEs with Labetalol?

A

fatigue
decreased HR
hypotension

18
Q

What are SEs of Hydralazine use in preganay?

A
  1. lupus-like syndrome
  2. fetal heart abnormalities
19
Q

What is eclampsia?

A

preeclampsia with seizures

20
Q

When is eclampsia most common?

A

3rd trimester or within 48h or delivery

21
Q

What is given to prevent eclampsia?

A

magnesium sulfate

22
Q

What is dosing for magnesium sulfate?

A

4-6g IV loading dose over 20-30 min
continuous IV infusion of 1-3g/h for 24h post delivery

23
Q

What are SEs with magnesium sulfate?

A

confusion
somnolence
respiratory distress
cardiac distress

24
Q

What is considered preterm delivery?

A

birth prior to 36.6 weeks

25
Q

How many weeks is a full-term birth?

A

40 weeks

26
Q

What is the age of viability?

A

24 weeks

27
Q

What is given to prevent premature delivery?

A

Betamethasone 12mg IM every 24h for 2 doses

28
Q

When should the mother be treated for HTN post-delivery?

A

> 150/110 on 2 readings 4-6 h apart

29
Q

What should be monitored in the baby if hydralazine or thiazide were used?

A

CBC due to thrombocytopenia cases

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