Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Maternal Newborn-MJ > T4-Hypertensive Disorders > Flashcards

T4-Hypertensive Disorders Flashcards

1
Q

Both gestational HTN and preeclampsia occurs 20 weeks after gestation. How do we determine the difference?

A

Preeclampsia is 20 weeks after gestation AND has proteinuria!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

If a patient is preeclamptic, they are 20 weeks gestation or more and have proteinuria. How do we know they have proteinuria. (2 ways)

A
  1. Proteinuria at or above 30 mg (1+ or greater on dipstick) in 2 random samples at least 6 hr apart

OR

  1. Protein is 300 mg or more in 24 hours
    * both in absence of UTI!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

_____ is HTN w/o proteinuria after 20 weeks gestation

A

Gestational HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

If patient has G. HTN, when does BP return to normal?

A

1-12 weeks after delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is preeclampsia?

A

HTN and proteinuria developed after 20 weeks!!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is mild preeclampsia?

A
  • BP 140/90 2x 4-6 hours apart
  • MAP greater than 105
  • 24 hour urine protein is 300 mg or greater (0.3 g)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is severe preeclampsia?

A
  • BP 160/110 or greater
  • MAP greater than 105
  • Urine protein greater than 2 grams in 24 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What can preeclampsia progress to?

A

HEELP syndrome or eclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is often the first sign of preeclampsia?

A

Elevated BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some other signs of preeclampsia other than the elevated BP?

A
  • Weight gain of more than 4.4 lbs in 1 wk
  • Edema in face, hands or abdomen that does not respond to 12 hours of bed rest
  • DTRs/clonus
  • Hyperreflexia
  • Blurred vision
  • Headaches
  • Liver functions
  • Epigastric pain (RUQ)
  • Low platelets (precursor to HEELP)
  • Proteinuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the only cure to preeclampsia?

A

Deliver baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the etiology of preeclampsia?

A

Disruption in placental perfusions and endothelial cell dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cause of preeclampsia:

Placental ischemia is thought to cause the endothelial cell dysfunction by stimulating the release of a substance toxic to endothelia cells. What does this anomaly cause?

A

Generalized vasospasm

  • poor tissue perfusion
  • increased peripheral resistance and BP
  • increased endo cell permeability–> less plasma volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Preeclampsia:

The main pathologic factor is NOT an increase in BP but _____ as a result of ____ and ____

A

Poor perfusion as a result of vasospasm and reduced plasma volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

_____ causes many of the common signs and symptoms of preeclampsia

A

Endothelial cell dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the drug to help with preeclampsia?

A

Mag sulfate

17
Q

How much mag is given..both loading and maintenance?

A

Loading: 4-6
Maintenance: 2-3

18
Q

What is antidote to mag?

A

Calcium gluconate

19
Q

What is management for mild preeclampsia?

A
  • *Bedrest (home or hospital)
  • Monitor BP
  • *Daily weights
  • Fetal surveillance
  • Monitor protein in urine
  • Teach pt. s/s
  • Healthy diet, good hydration
  • Emotional support
20
Q

What is management in severe preeclampsia?

A
  • Hospital bed rest
  • Maternal and fetal surveillance (possibly in ICU)
  • Quiet, non stimulating environment; seizure precautions
  • Drug interventions
  • Delivery
21
Q

What is given post delivery to prevent the development of eclampsia?

A

Mag sulfate administered 12-24 hours post delivery

22
Q

Mag. sulfate is good to prevent dev of eclampsia post delivery. But what can it interfere with?

A

-Uterus clamping down causing boggy uterus and heavy lochial flow (PPH!!! risk)

Give oxytocin to treat boggy and control uterus

DO NOT GIVE methergine and ergotratate– remember methergine increases BP!

23
Q

PP for preeclamptic patient…BP should be monitored every ____ for ___

A

q4h for 48 hrs

24
Q

PP for preeclamptic pt…We give mag sulfate PP to prevent development of eclampsia. What drug should we give with cation with mag and why?

A

Analgesics; mag sulfate potentiates their effects

25
Q

PP for preeclamptic pt…Since we give mag sulfate to prevent the development of eclampsia, should we promote or discourage breastfeed? Explain

A

Encourage! Breastfeeding is best form of nutrition for premature infant and mag sulfate is NOT a contraindication for breast feeding!

26
Q

What does HEELP stand for?

A

Hemolysis
Elevated liver enzymes
Low platelets

27
Q

What kind of diagnosis is HEELP?

A

Lab diagnosis NOT clinical

28
Q

What are s/s of preeclampsia ?

A

Range from no s/s of preeclampsia to NV, epigastric/RUQ pain, and general malaise

29
Q

DIC is always a ____ diagnosis

A

Secondary

30
Q

What are platelets like in DIC?

A

Reduced

31
Q

What is fibrinogen like in DIC?

A

Reduced

32
Q

What is fibrin degradation products like in DIC?

A

Elevated

33
Q

What is PT like in DIC?

A

Normal or prolonged

34
Q

What is PTT like in DIC?

A

Sometimes prolonged

35
Q

What is thrombin test time like in DIC?

A

Prolonged

36
Q

What is d-dimer test like in DIC?

A

High level

Positive d dimer tells there is high level of fibrin degrading products in body–aka there has been significant clot formation and breakdown in body

37
Q

What is protamine like in DIC?

A

Positive

Maternal Newborn-MJ (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions