Pregnancy and Kidney Disease- Das Flashcards
key anatomical change to kidney during pregnancy
changes to renal pelvis
normal creatinine in patient who is pregnant means what
a problem; it should decline
in _____, glucose can still be in urine w/out exceeding renal threshold
pregnancy
what threshold is decreased during pregnancy
threshold for AVP/ADH release
in a pregnant patient with CKD, what risk increases dramatically
risk for preeclampsia
advanced CKD (severe) has what serum creatinine
> 2.4
as serum creatinine gets higher, ______ in pregnancy increases
problems
as serum creatinine increases during pregnancy, what decreases
fetal growth
first step in assessment of fetal well-being
non-stress test
2nd step to assess fetal well-being
ultrasonic (amniotic fluid, fetal breathing and movements)
how to assess fetal umbilical artery vascular resistance
umbilical artery doppler assessment
what is a major risk factor for complications during pregnancy
HTN
4 types of HTN seen in pregnancy
chronic HTN
gestational HTN
pre-eclampsia
white coat HTN
sometimes during the progression of pregnancy there is a natural decline in what
blood pressure
what happens if you reduce bp too much in pregnant patient
fetal growth is impaired
if you dont control bp= higher frequency of severe maternal ____
HTN
if you achieve a bp goal of ______ = better pregnancy outcomes
140/90
what medication used for HTN is contraindicated in pregnancy
ACEIs and ARBs
least risk of pregnancy complications with HbA1c of ____
7
target bp for pregnant patient w/ diabetes and HTN and proteinuria
<130/80
4 maternal/neonatal outcomes for pregnant patient with diabetes and HTN
preeclampsia
renal impairement
microvascular disease
neonatal outcomes poor
what medication to start to prevent preeclampsia
aspirin
main thing to do for managing bp and bg for pregnant patient
reassure the patient
pregnant pt has worsening lower extremity edema and protein in urine; what med to give
diuretic
