NURS U340 STUDY GUIDE QUESTIONS AND ANSWERS
Most common medical complication reported during pregnancy: - HTN
Gestational HTN - onset of HTN after 20 weeks with no proteinuria
Pre-eclampisa - onset of HTN after 20 weeks + proteinuria
OR
onset of HTN after 20 weeks + ANY of these: thrombocytopenia, renal
insufficiency, impaired liver function, pulmonary edema, vision issues
**ONSET OF HTN: SBP greater than or equal to 140 or greater than or equal to
90 GREATER THAN 20 WEEKS
BEST definition for preeclampsia - idiopathic multisystem syndrome of pregnancy
involving reduced organ perfusion due to vasospasm
MOST telling maternal symptom of preeclampsia: - "just don't feel right"
others include: generalized edema, weight gain >5 lbs in 1 week, epigastric pain,
HA unrelieved by Tylenol, visual changes
Diagnostic criteria of severe preeclampsia includes any of these: - SBP > or = 160 /
DBP > or = 110
oliguria
,epigastric, RUQ pain
thrombocytopenia
impaired liver/renal function
pulmonary edema
cerebral/visual issues
Eclampsia - onset of seizure activity due to cerebral vasospasm r/t pre-e
WARNING signs of eclampsia: - HA, severe epigastric pain, n/v, hyperreflexia,
scotoma, blurred vision, hemoconcentration, NO WARNING
Can seizures occur PP? - YES up to 48-72 hours PP
Tx of seizure - AIRWAY, O2, FHR (late decels), FLUIDS (100-125 mL/hr)
Cure for preeclampsia - delivery of baby and placenta
Pre-e or GHTN at 37 weeks: - delivery
Pre-e or GHTN w/ severe features at 34 weeks: - delivery
Should diuretics be used to tx pre-e or GHTN? - NO! -- will decrease perfusion to
baby due to decreasing the BV
Proteinuria diagnostic criteria: - 24 hour urine specimen: 300mg / day
Ratio: 0.3
, Dipstick: +1 protein
MgSO4 function - CNS depressant, smooth muscle relaxant
1/2 risk of eclampsia and reduces risk of maternal death
ALSO--neuroprotection of baby
Pitocin and MgSO4 - work against each other--pitocin should not used if recently
given MgSO4 and if used we will need A LOT of it
MgSO4 and Kidneys - NEED ADEQUATE KIDNEY FUNCTION (30mL/hr)
otherwise TOXICITY can ensue
MgSO4 therapeutic serum level - 4-7
Normal symptoms of MgSO4 - nausea, feeling of warmth, flushing
Signs of MgSO4 toxicity - muscle weakness, hyporeflexia, slurred speech,
respiratory depression, oliguria, decreased LOC
MgSO4 antidote: - calcium gluconate
Nursing considerations with MgSO4: - double check
1) at shift change
2) dose change
3) started
Most common medical complication reported during pregnancy: - HTN
Gestational HTN - onset of HTN after 20 weeks with no proteinuria
Pre-eclampisa - onset of HTN after 20 weeks + proteinuria
OR
onset of HTN after 20 weeks + ANY of these: thrombocytopenia, renal
insufficiency, impaired liver function, pulmonary edema, vision issues
**ONSET OF HTN: SBP greater than or equal to 140 or greater than or equal to
90 GREATER THAN 20 WEEKS
BEST definition for preeclampsia - idiopathic multisystem syndrome of pregnancy
involving reduced organ perfusion due to vasospasm
MOST telling maternal symptom of preeclampsia: - "just don't feel right"
others include: generalized edema, weight gain >5 lbs in 1 week, epigastric pain,
HA unrelieved by Tylenol, visual changes
Diagnostic criteria of severe preeclampsia includes any of these: - SBP > or = 160 /
DBP > or = 110
oliguria
,epigastric, RUQ pain
thrombocytopenia
impaired liver/renal function
pulmonary edema
cerebral/visual issues
Eclampsia - onset of seizure activity due to cerebral vasospasm r/t pre-e
WARNING signs of eclampsia: - HA, severe epigastric pain, n/v, hyperreflexia,
scotoma, blurred vision, hemoconcentration, NO WARNING
Can seizures occur PP? - YES up to 48-72 hours PP
Tx of seizure - AIRWAY, O2, FHR (late decels), FLUIDS (100-125 mL/hr)
Cure for preeclampsia - delivery of baby and placenta
Pre-e or GHTN at 37 weeks: - delivery
Pre-e or GHTN w/ severe features at 34 weeks: - delivery
Should diuretics be used to tx pre-e or GHTN? - NO! -- will decrease perfusion to
baby due to decreasing the BV
Proteinuria diagnostic criteria: - 24 hour urine specimen: 300mg / day
Ratio: 0.3
, Dipstick: +1 protein
MgSO4 function - CNS depressant, smooth muscle relaxant
1/2 risk of eclampsia and reduces risk of maternal death
ALSO--neuroprotection of baby
Pitocin and MgSO4 - work against each other--pitocin should not used if recently
given MgSO4 and if used we will need A LOT of it
MgSO4 and Kidneys - NEED ADEQUATE KIDNEY FUNCTION (30mL/hr)
otherwise TOXICITY can ensue
MgSO4 therapeutic serum level - 4-7
Normal symptoms of MgSO4 - nausea, feeling of warmth, flushing
Signs of MgSO4 toxicity - muscle weakness, hyporeflexia, slurred speech,
respiratory depression, oliguria, decreased LOC
MgSO4 antidote: - calcium gluconate
Nursing considerations with MgSO4: - double check
1) at shift change
2) dose change
3) started
