N4341 - EXAM 2 (OB - HOOLAPA/WELCH)
QUESTIONS WITH 100% CORRECT 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!)
QUESTIONS WITH 100% CORRECT 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!)
