NR 327(NR 327) Pregnancy complications part 1 (1) Final Exam 2022/2023: NSG 211(NSG 211) Maternity Nursing: NSG 4052 (NSG-4052) Community Health Nursing:
... [Show More] With Complete Solutions (Chamberlain College of Nursing)
when must HTN be present to be considered chronic HTN in pregnancy
{{Ans- before pregnancy or before 20 weeks of gestation or persists longer than the postpartum period (12 weeks after gestation)
when does gestational HTN develop?
{{Ans- for the first time after 20 weeks gestation in absence of proteinuria
how does preeclampsia differ from gestational HTN
{{Ans- in preeclampsia, there is HTN present AND proteinuria after 20 weeks gestation
gestational HTN is HTN without proteinuria after 20 weeks gestation
what is eclampsia
{{Ans- additional presence of convulsions in women with preeclampsia that is not explained by neurologic disorder
HELLP syndrome {{Ans- hemolysis, elevated liver enzymes, low platelets
maternal vasospasm {{Ans- sudden constriction of a blood vessel
what is maternal vasospasm (sudden constriction of blood vessels), a predominant finding in?
{{Ans- in women with gestational HTN and preeclampsia
what affect does maternal vasospam have on CV? {{Ans- increased BP
effect of MV on hematologic
{{Ans- increase hematocrit from plasma vol contraction, thrombocytopenia, DIC< hepatoelllar dysfunction and third spacing
effects of MV on renal
{{Ans- decreased GFR and proteinuria
-decreased filtration of uric acid
neuro effects from maternal vasospasm {{Ans- HA, blurred vision, scotomatia, hyperreflexia
what affect does MV have on fetus
{Ans- decreased placental perfusion and increased incidence of placental abruption
what is the diagram showing?
{{Ans- how a vasospasm can cause oliguria and low proteinuria as well as blurred vision, flashing lights and scotoma
what BP for chronic HTN? when does it need to be diagnosed
{{Ans- 140/90 or greater
and is diagnosed before pregnancy, before 20 works of gestion or continues 12 weeks after birth
mild, mod, severe chronic HTN in pregnancy
{{Ans- mild: 140/90mm Hg
moderate: 150/100mm Hg
Severe: 160/110mmHg
how often to monitor for chronic HTN in pregnancy?
{{Ans- every 2-4 weeks and weekly between 34-36weeks
when might you recommend delivery due to chronic HTN {{Ans- at 37 weeks
how to mange chronic HTN in pregnancy? {{Ans- Labetolol or Nifedipine
can you use ACEi or ARBs for chronic HTN in pregnancy {{Ans- NO they are contraindicated
what is gestational HTN
{{Ans- new onset HTN 140/90 or > After 20 weeks gestation with no proetinuira, edema or EOD
how to manage gestational HTN
{{Ans-
1. check weekly BP, protein in urine, platelets and liver enzymes
2. US monthly to monitor for IUGR and weekly non stress testing in 3rd trimester
IUGR {{Ans- intrauterine growth restriction
how to manage severe gestational HTN
{{Ans- medication to reduce stroke risk:
1. labetolol
2. nifedipine
3. methyldopa
what fraction of patients with gestational HTN progress to pre-eclampsia {{Ans- 1/3rd
define pre-eclampsia
{{Ans- new onset HTN >/=140/90 after 20 weeks gestation + proteinuria or end organ damage in a previously normotensive female
what is considered proteinuria In pre-eclampisa?
{{Ans- urinary excretion of 0.3g (300mg) protein or higher in 24 hour urine specimen
does proteinuria have to be present in pre-eclampsia? {{Ans- no
if proteinuria is not present in pre-e then what is the criteria?
{{Ans- new onset HTN with the new onset of any of the following:
1. thrombocytopenia (platelets <100,000)
2. renal insufficiency (SCr>1.1)
3. impaired liver function (liver transaminase 2x normal)
4. pulm edema
5. persistent cerebral or visual sxs
preeclampsia pathophysiology
{{Ans- HELLP
hemolysis
elevated liver enzymes
low platelets
what labs for preeclampsia?
{{Ans-
1. liver function
2. SCr
3. platerles
4. CC [Show Less]