N4341 Latest Exam 2 (OB) Questions
And Already Passed Answers.
What BP during pregnancy is considered hypertensive?
Severe hypertension? - Answer >140/90
severe: >160/110
Qualifications for chronic HTN during pregnancy (2) - Answer HTN before 20 weeks
OR
lasting >12 weeks after PP
What are the types of hypertensive disorders associated with pregnancy? (5) - Answer gestational HTN
(no protein in urine)
preeclampsia (protein in urine)
eclampsia (pre-e w/ seizures)
HELLP (hemolysis of RBC, elevated liver enzyme, low platelets)
chronic HTN with superimposed preeclampsia
Risk factors for hypertensive disorders during pregnancy (6) - Answer first child w/ new partner
hydatidiform mole
diabetes
multiple gestation (twins)
primigravida
age extremes of <17 or >40
Discuss the scoring of fetal station - Answer -4 = floating
0 = at ischial spines
+4 = crowning
,Define when gestational HTN occurs - Answer after 20 weeks
OR
within first 24h after delivery w/out protein in urine
To be considered hypertensive, blood pressure must be _____ on ____ occasions at least _____ apart. -
Answer BP >140/90 on 2 separate occasions at least 6 hours apart
When is gestational HTN expected to return to normal?
Otherwise what? - Answer BP will return to normal ~12 weeks after delivery
otherwise it's now chronic HTN
What are the defining characteristics of preeclampsia? (2) - Answer proteinuria of +1 on dipstick OR
>300mg in 24hr urine
edema of face, hands, sacrum
Complications of preeclampsia to mother (7) - Answer pulmonary edema
oliguria
thrombocytopenia
headaches
hyperreflexia
blurred vision
seizures
Pregnant mother with preeclampsia is complaining of right upper quadrant pain, what do you suspect? -
Answer liver involvement from pre-e
How does preeclampsia affect fetal heart rate? (2) - Answer *pre-e reduces placental perfusion*
late decels
↓ variability
, Effects of pre-e on fetus (3) - Answer IUGR
fetal hypoxia (AEB late decels and ↓ variability)
oligohydramnios (<500)
Why would glucocorticoids be prescribed for a pre-e mom? - Answer for fetal lung maturity (in case
delivers preterm) given to ↑ surfactant production in fetus
*takes ~48h to kick in, must repeat q 7 days
What is the average fluid restriction to manage pre-e? - Answer 125 mL/hr
What is the MOA of MgSO₄? (2)
What does each MOA result in? - Answer ↓CNS excitability ∴ seizure prevention
smooth muscle relaxer ∴ ↓BP (watch it doesn't go too low!)
Note regarding using pitocin with magnesium (2) - Answer pitocin does NOT ↑BP
will need to use more pitocin to induce ctx ∵ mag being a smooth muscle relaxer
MgSO₄ should be used cautiously if patient has what type of preexisting condition? - Answer renal
impairment
Patient with pre-e now experiences a seizure, this is now classified as ________. What will you prepare
for? - Answer now classified as eclampsia
prepare for delivery!
Pregnant patient with chronic HTN now presents with +2 protein in urine, what is this classified as?
At greater risk for what? (2) - Answer classified as chronic HTN w/ pre-e
↑ risk of intracranial bleed and abruption
Patient on MgSO₄ drip has decreasing deep tendon reflexes, what is happening?
S/S (4) - Answer ↓ DTR = mag toxicity!
And Already Passed Answers.
What BP during pregnancy is considered hypertensive?
Severe hypertension? - Answer >140/90
severe: >160/110
Qualifications for chronic HTN during pregnancy (2) - Answer HTN before 20 weeks
OR
lasting >12 weeks after PP
What are the types of hypertensive disorders associated with pregnancy? (5) - Answer gestational HTN
(no protein in urine)
preeclampsia (protein in urine)
eclampsia (pre-e w/ seizures)
HELLP (hemolysis of RBC, elevated liver enzyme, low platelets)
chronic HTN with superimposed preeclampsia
Risk factors for hypertensive disorders during pregnancy (6) - Answer first child w/ new partner
hydatidiform mole
diabetes
multiple gestation (twins)
primigravida
age extremes of <17 or >40
Discuss the scoring of fetal station - Answer -4 = floating
0 = at ischial spines
+4 = crowning
,Define when gestational HTN occurs - Answer after 20 weeks
OR
within first 24h after delivery w/out protein in urine
To be considered hypertensive, blood pressure must be _____ on ____ occasions at least _____ apart. -
Answer BP >140/90 on 2 separate occasions at least 6 hours apart
When is gestational HTN expected to return to normal?
Otherwise what? - Answer BP will return to normal ~12 weeks after delivery
otherwise it's now chronic HTN
What are the defining characteristics of preeclampsia? (2) - Answer proteinuria of +1 on dipstick OR
>300mg in 24hr urine
edema of face, hands, sacrum
Complications of preeclampsia to mother (7) - Answer pulmonary edema
oliguria
thrombocytopenia
headaches
hyperreflexia
blurred vision
seizures
Pregnant mother with preeclampsia is complaining of right upper quadrant pain, what do you suspect? -
Answer liver involvement from pre-e
How does preeclampsia affect fetal heart rate? (2) - Answer *pre-e reduces placental perfusion*
late decels
↓ variability
, Effects of pre-e on fetus (3) - Answer IUGR
fetal hypoxia (AEB late decels and ↓ variability)
oligohydramnios (<500)
Why would glucocorticoids be prescribed for a pre-e mom? - Answer for fetal lung maturity (in case
delivers preterm) given to ↑ surfactant production in fetus
*takes ~48h to kick in, must repeat q 7 days
What is the average fluid restriction to manage pre-e? - Answer 125 mL/hr
What is the MOA of MgSO₄? (2)
What does each MOA result in? - Answer ↓CNS excitability ∴ seizure prevention
smooth muscle relaxer ∴ ↓BP (watch it doesn't go too low!)
Note regarding using pitocin with magnesium (2) - Answer pitocin does NOT ↑BP
will need to use more pitocin to induce ctx ∵ mag being a smooth muscle relaxer
MgSO₄ should be used cautiously if patient has what type of preexisting condition? - Answer renal
impairment
Patient with pre-e now experiences a seizure, this is now classified as ________. What will you prepare
for? - Answer now classified as eclampsia
prepare for delivery!
Pregnant patient with chronic HTN now presents with +2 protein in urine, what is this classified as?
At greater risk for what? (2) - Answer classified as chronic HTN w/ pre-e
↑ risk of intracranial bleed and abruption
Patient on MgSO₄ drip has decreasing deep tendon reflexes, what is happening?
S/S (4) - Answer ↓ DTR = mag toxicity!
