Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
43 Cards in this Set
- Front
- Back
|
what is considered hypertension/
|
140/90
|
|
|
what is considered chronic hypertension?
|
hypertension before conception or before the 20th week of gestation, puts the women at higher risk for developing preeclampsia
|
|
|
what is preeclampisa?
|
a systemic disease with hypertension accompanied by protienuria after the 20th week of gestation.
|
|
|
what is eclampsia?
|
is a convulsive stage of preeclampsia
|
|
|
what is the difference between gestational hypertension during pregnancy and preeclampsia?
|
protien in the urine
|
|
|
what makes preeclampsia so dangerous in the women?
|
preeclampsia is associated with vasospasm and reduced renal perfusion
|
|
|
what are some risk factors for women who have a potential to develop preeclampsia?
|
over the age of 35
multiple gestation DM hydatidiform mole |
|
|
what does preeclampsia put pregnant women at risk for?
|
CVA
DIC renal failure hepatic rupture |
|
|
t/f in normotensive women the placenta is remodeled by endovascular trophblast cells allowing for an increase perfusion in blood flow
|
true- in preeclampsia the remodeling is incomplete resulting in decreased perfusion to the placenta
|
|
|
if uteroplacental perfusion is less than adequate what can happen?
|
can lead to endothelial cell dysfunction and mulitorgan endothelial cell dysfunction which triggers vasospasm leading to increased blood pressure
|
|
|
what is considered mild preeclampsia?
|
BP of 140/90 on two occasions at least 7 days apart after 20wks gestation and 1-2+ proteinuria
|
|
|
what is considered severe preeclampsia?
|
BP of 180/110 on 2 occasions at least 6 hr apart while on bedrest and porteinuria of 3-4+
|
|
|
what is HELLP syndrome?`
|
associated with severe preeclampisa stands for
hemolysis (breakdown of RBC) elevated liver enzymes low platelet count (below 100000) |
|
|
why is HELLP syndrome dangerous?
|
can lead to periportal hemorrhagic necrosis of the liver which can lead to subcapsular hematoma
|
|
|
what will the client complain of if she develops HELLP syndrome?
|
RUQ pain or epigastric pain
|
|
|
______ is a sign of worsening preeclampsia and kidney damage.
|
oliguria
|
|
|
why does thrombocytopenia occur in preeclampsia?
|
could be due to increased platelet aggregation and deposition at sites of endothelial damage, this activates a clotting cascade
|
|
|
when there is endothelial damage in the brain what is the results?
|
fibrin deposition, edema, cerebral hemorrhage, which can lead to hyperreflexia and severe headaches/ may progress to eclampsia
|
|
|
in patients with preeclampsia what can be some eye complaints stated by the client>
|
blurring vision, double vision, photophobia or scotoma, this is caused by retinal arterial spasms
|
|
|
what are some risks to the fetus if the mother develops preclampsia?
|
prematurity
IUGR LBW fetal intolerance r/t decreased renal perfusion stillbirth |
|
|
what are the drugs used to lower blood pressure?
|
hydralazine(apresoline neopreol)
methyldopa (aldomet) labetalol (beta blocker) nifedapine (procardia) |
|
|
what is hydralazine?
|
a vasodilator used in severe preeclampsia cation cause it can dramatically drop blood pressure
|
|
|
what is methyldopa?
|
used on alzheimers disease then pulled of the market but now used for severe preeclamptic pt, exact mechanism is unknown but works on the CNS
|
|
|
what is labetalol
|
it is a beta blocker that slows the heart rate and decreases systemic vascular resistance
|
|
|
what is nifedapine? (procardia)
|
calcium channel blocker controls hypertension rapidly, increases cardiac index and increases urinary output
|
|
|
why do we ausculatae lung sounds in a patient with preeclampsia?
|
decreased cardiac output can increase pulmonary edema
|
|
|
what kind of diet should preeclamptic pt consume?
|
high protein without salt restriction
|
|
|
why would we not restrict salt?
|
may result in hypovolemia (decreased blood volume)
and fetal distress |
|
|
what should a normal DTR in pregnancy be?
|
2+
|
|
|
what should be the response of clonus?
|
neg
|
|
|
what test would we use to monitor the fetus if the mother has preeclampsia?
|
EFM
NST BPP amniocentesis |
|
|
why would we use mag sulfate in a patient with severe preeclampsia?
|
for sz pervention
|
|
|
what is the therapeutic level of mag?
|
5-8 ml/dl
|
|
|
what can you start to see if the patients mag level is at 9ml/dl?
|
altered LOC
|
|
|
what can you see if the mag level is at 19mg/dl?
|
loss of DTR and LOC
|
|
|
what is used to counteract mag levels that are no longer therapeutic?
|
calcium gluconate
|
|
|
HELLP syndrome occurs most often in?
|
white,older,multipara women
|
|
|
how do we detect proteinuria?
|
30mg/dl in two random UAs at least 6 hours apart
|
|
|
what is another way to detect protein in the urine?
|
a 24 hour sample with at least 300mg/L
|
|
|
what does it mean when there is 2g/L of protein in a 24 hour urine specimen?
|
severe preeclampsia
|
|
|
why does IUGR happen in women with severe preeclampsia?
|
decreased perfusion to the fetus
|
|
|
what is the mom at risk for if she has a sz?
|
aspiration, death
|
|
|
what is the baby and mom at risk for if there is a sz?
|
hypoxia
|
