Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
High Risk
Hypertension
| Question | Answer |
|---|---|
| Chronic hypertension is classified as | >140/90 BEFORE 20 wks gestation |
| Gestation HTN is classified as | >140/90 20 wks or greater gestation |
| Mild preeclampsia has __ protein and ___ urine | +1 protein; >300 mg/24hr urine |
| T or F: Mild preeclampsia does not have weight gain r/t fluid retention | FALSE. Mild preeclampsia DOES show wt. gain r/t fluid retention |
| Mild preeclampsia has edema located in __ | Face and hands |
| What PO meds are given for mild preeclampsia? | Nifedipine, Labetolol unless BP continues to increase. Then will Tx with stronger HTNsives until Mag Sulfate is needed. |
| Mild preeclampsia PLTs may be... | Normal |
| Severe preeclampsia shows BP reading of __/__ | >160/110 |
| Mild preeclampsia shows BP reading of __/__ | >140/90 |
| The classic triad of sx for preeclampsia include | Edema, proteinuria, hypertension |
| Severe preeclampsia has __ protein on dipstick, __ mg/__ hours urine | 3+ protein, >500 mg/24hr urine |
| T or F: severe preeclampsia shows 2+ DTRs | False. Will have 3+/4+ DTRs since hyperreflexia a sx |
| T or F: severe preeclampsia, mother may complain of headache | True |
| Severe preeclampsia shows edema in what places? | Generalized, including face/hands |
| Mother may c/o ____ r/t fluid retention in severe preeclampsia | Weight gain |
| Oliguria presents in which HTN disorders? | Severe preeclampsia, eclampsia |
| If a mother with HTN c/o of epigastric or RUQ pain, you suspect which organ is affected? Which HTN category will these sx appear in? | Liver; epigastric/RUQ pain presents in severe preeclampsia/eclampsia |
| Scotomata refers to ___ and is seen if the mother has ___ | Blind spots; severe preeclampsia/eclampsia |
| True or false: Blurry vision is a sx of gestational hypertension | False. Blurry vision sx of severe preeclampsia/eclampsia |
| Pulmonary edema is seen in pts. with ______ | Severe preeclampsia/eclampsia |
| HELLP stands for | Hemolysis, elevated liver enzymes, low platelets |
| HELLP presents during... | Severe preeclampsia/eclampsia |
| True or false: magnesium sulfate should not be given with Pitocin d/t its toxic effects | False. Mag Sulfate can be used with Pitocin |
| True or false: Thrombocytopenia is seen in severe preeclampsia and eclampsia. Lab values show plats are < 150,000 | False. Lab values show PLT < 100,000 |
| Chronic HTN is assessed during __ trimester and before __ wks | 1st, before 20 wks |
| Gestation HTN is assessed in __ trimester and after __ 20 wks | 2nd, 3rd trimester, AFTER 20 wks |
| What are recommendations for women with chronic HTN/GH? | Reduce activity, treat with antihypertensives like labetolol/procardia (aka nifedipine) |
| True or False: gestational HTN may be asymptomatic | True |
| When D/C teaching, you tell a mother that chronic HTN does __ postpartum | NOT resolve |
| What is the primary mechanism of GH? | Vasospasm; hypo-perfusion of mother's organs/placental blood flow... may affect all organ systems |
| A mother with GH explains to you that her HTN will go away by 2 wks pp. How do you respond? | Explain elevated BP goes away usually by 12 wks PP. |
| _____ is an ominous sign before seizure (eclampsia) | Epigastric pain |
| ___ therapy is used preventatively to decrease what in high risk moms? | Aspirin therapy; used to decrease vessel wall damage |
| List 6 major MATERNAL complications of preeclampsia | 1) seizures, 2) placental abruption, 3) retinal detachment, 4) renal failure, 5) cerebral hemorrhage, 5) HELLP/liver rupture |
| List 4 major FETAL complications of preeclampsia | 1) IUGR, 2) chronic hypoxemia, 3) acute hypoxemia, 4) death |
| A baby whose mother has preeclampsia will show a __ HCT level | High (d/t chronic hypoxemia) |
| When a mother is Dx with a HTNsive disorder, you must do what types of fetal tests? | Fetal US, weekly NST (non-stress test), amnio (lung maturity), doppler velocimetry (blood flow) |
| You ask the mother to count daily fetal kicks. She asks what is "normal" amount of kicks for a healthy baby. You respond... | 12 kicks/day, or track # kicks/1-2 hrs your baby usually does. |
| A mother has her Magnesium levels drawn. Results: 8.9. You know this is a __ level. | High! Normal mag levels are 4-7 |
| What sort of adverse effects should you warn a mother about Mag Sulfate? | Dizzy, hot flashes, difficulty catching breath |
| How often should you draw Mag levels? | q6h |
| Activity level while on Mag should be | Strict bedrest |
| S/sx of magnesium toxicity include | Depressed RR (<12), decreased LOC, absent reflexes/clonus, urine output < 30cc/hr |
| The antidote to mag toxicity is ___ | Calcium gluconate |
| True or false: you will always see a rise in BP before HELLP presents | FALSE. 20-25% cases have HTN absent before mother presents with HELLP |
| Preterm labor is defined as | Mother going into labor before completed 37th week |
| Requirements for PTL include what type of uterine cx and cervical dilation? | Regular uterine cx (4/20min or 8/1 hr) and cervical dilation >=2 |
| Risk factors for PTL include | Hx of PTL, low literacy, "rule of toos" |
| Causes of PTL | Infection, stress, trauma, multiples |
| Fetal fibronectin (fFN) does what? Why is it used diagnostically? | Attaches amniotic sac to lining of uterus. Increased levels BEFORE 35 wks shows risk of PTL |
| First thing you do with mother at risk of PTL | HYDRATION. Dehydration may encourage woman to contract |
| If rest/hydration doesn't work for PTL, then give what? | Drugs: Mag sulfate, terbutaline, nifedipine, NSAIDs (motrin) |
| Why is Mag sulfate used for PTL? | Relaxes uterus |
| Mag sulfate doses: loading vs. maintenance | 4 gm loading over 20 minutes, then 1 gm/hr |
| Terbutaline does what for PTL? | Relaxes uterus |
| Terbutaline should raise heartrate to ____ for therapeutic range | above 110 |
| True or false: betamethasone requires 2 doses 24 hours apart | True |
| Why is betamethasone given to PTL moms? | Increases surfactant production of babies' lungs, help maintain inflation of lungs |
| What HIV drug is given at any stage of pregnancy to woman and NB? | AZT |
| Management of newborn delivered by HIV+ mom | Bathe on admission, treat with AZT |
| Why is C-S preferred in HIV+ mom? | Less blood exchange, more control, less trauma |
| Leading cause of PROM/PTL | Infection (#1 UTI, also dental) |
| Why does infection cause PTL? | Release of prostaglandins |
| ___ is known as infection of amniotic sac and typically has a "death smell" | Chorioamniitis |
| When should GBS be Tx? | During labor, 1 dose 4 hours BEFORE birth for baby |
| S/sx of sepsis in baby | Very cold or warm, mottled skin, poor feeding, fussy, lethargic, acts "sick" |
| S/sx of chorio in mom | Abd pain, elevated WBC |
| Predisposing factors to UTI | Hygiene, nutrition, anemia, DIABETES |
| _________ is considered teratogenic | Hyperglycemia |
| What DOES NOT cross placenta? | Insulin |
| Macrosomia is seen in mothers with | Diabetes |
| First line Tx of diabetes: | Diet, exercise, BG control |
| Second line Tx of diabetes | PO meds (Glyburide) |
| Third line Tx of diabetes | Insulin |
| S/sx of hypoglycemic babies | Shaky, poor feeding, fussy, sweating |
| Gestational DM should resolve in __ | 6 weeks |
| Important teaching points to moms with gestational diabetes (about mom and baby): | Mother's chances of getting DMII is 60%, baby 45% more likely to have Metabolic Syndrome as adults |
| Babies born from diabetic moms should have __ BG checks and if < __ give formula/colostrum | 4-6 BG checks. If <45 give formula/colostrum |
| When is gestational diabetes detected? | 2nd and 3rd trimester by GTT (glucose tolerance test). If obese, do GTT in 1st trimester |
| List maternal complications of diabetes (5) | 1) Ketoacidosis, 2) hypoglycemia, 3) INFECTION, 4) PIH, 5) hemorrhage |
| List newborn complications of diabetes (3) | Hypoglycemia, macrosomia d/t hyperinsulinemia, IUGR if diabetes + severe PIH |
Created by:
lapio-obgyn
Popular Nursing sets