Unit 7: Perfusion and Clotting Flashcards
What is perfusion?
The flow of blood that delivers nutrients and oxygen.
A normal physiological process that requires the heart to generate sufficient cardiac output to transport blood
How does hypertension relate to perfusion?
Most common medical complication that is a contributor to maternal and perinatal morbidity and mortality.
Hypertension decreases perfusion to tissues.
What is gestational hypertension?
> 140/90 blood pressure
Recorded on 2 occasions at least 4 hours apart after 20 weeks of gestation
No proteinuria
What is Preeclampsia?
hypertension and proteinuria develop after 20 weeks of gestation
What is eclampsia?
Sudden increase in blood pressure
OR
New onset of proteinuria or sudden, sustained increased proteinuria
What is Chronic Hypertensive disorders?
Hypertension present before 20 weeks of gestation and persists after birth
No proteinuria
What are risk factors for preeclampsia?
Age (>35)
Hx of preeclampsia
Chronic hypertension
Multifetal pregnancy
First pregnancy
New paternity
Race (blacks)
Obesity (BMI>30)
Chronic disease (diabetes, lupus, sleep apnea)
What is the pathophysiology of preeclampsia?
Inadequate vascular remodeling which leads to decreased placental perfusion and hypoxia.
This leads to cell dysfunction and decreased tissue perfusion.
“The main pathogenic factor is not an increase in BP but poor perfusion as a result of vasospasm and reduced plasma volume.”
What is HELLP Syndrome?
A laboratory diagnosis for a variant of preeclampsia that involves hepatic dysfunction.
Characterized by hemolysis, elevated liver enzymes, and low platelet count.
What is disseminated intravascular coagulation (DIC)?
Accelerated clotting leading to increased consumption of platelets and clotting factors which causes uncontrollable bleeding.
What labs confirm DIC and what is the treatment?
PT (elevated), aPTT (elevated), D-Dimer (elevated), CBC (low platelet), and Fibrinogen levels (low)
Management of the underlying condition, blood products, and supportive care
What are cues of preeclampsia?
Edema
Headache
BP >140/90
Proteinuria >+1
Blurred vision
Right upper quadrant pain
Reflex 3+
What are the nursing interventions for clients with preeclampsia?
Deliver as close to term as possible
Monitor BP, kick counts (10/hr), and have frequent healthcare visits
Reduce stress
Low-dose aspirin
What are complications of preeclampsia
Damage to the kidneys, liver, lung, heart, or eyes, and may cause a stroke or other brain injury
What is magnesium sulfate administration?
IV medication, a primary line
Piggyback solution of 40 g of magnesium sulfate in 1000mL of LR
Verify with another nurse
