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Nsg 210 Questions and Answers Already Graded

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Nsg 210 Questions and Answers Already Graded


Q: Pre-eclampsia ✓✓ most common hypertensive disorder of
pregnancy, develops with proteinuria after 20 weeks' gestation


Eclampsia ✓✓ Onset of seizure activity in a woman with
preeclampsia.


Gestational Hyperternsion ✓✓ blood pressure elevation (140/90
mm Hg) identified after 20 weeks' gestation without proteinuria.
Blood pressure returns to normal by 12 weeks' postpartum.


Supplementation with this during the 1st trimester significantly
reduces gestation HTN and fetal distress in primigravida women?
✓✓ Progesterone


S/S of severe preeclampsia ✓✓ >160/110 BP
W/out seizures
Headache
Oliguria
Blurred vision, scotomata (blind spots)
Pulmonary edema
Thrombocytopenia (platelet count <100,000 platelets/mm3)
Cerebral disturbances
Epigastric or RUQ pain
HELLP



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,S/S eclampsia ✓✓ >160/110 BP
with seizures
Severe headache
Generalized edema
RUQ or epigastric pain
Visual disturbances
Cerebral hemorrhage
Renal failure
HELLP


What are the 2 stage of pre-eclampsia? ✓✓ 1st-wide spread vaso
spasm
2nd-woman's response to abnormal placentation, when symptoms
appear, that is, hypertension, proteinuria, and edema due to
hypoperfusion.


Management of pre-eclampsia (Home) ✓✓ Bed rest
Rest in lateral recumbent position to improve uteroplacental blood
flow, decrease BP, promote diuresis
More frequent doctor visits and labs (CBC, liver enzymes, clotting
studies, platelet levels)
Client will monitor BP every 4-6 hrs while awake
Client will measure protein in urine
Weigh Daily
Balanced nutritional diet with no salt
Drink 6-8 8 oz water/day




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,Mgmt of pre-eclampsia (Hospital) ✓✓ Monitor for s/s of severe pre-
eclampsia
Bp recorded frequently
Daily weights (excessive weight gain from edema)
Fetal movement counts
Nonstress test
Ultrasound (tetal growth and amniotic fluid)
Watchful waiting


Medications for pre-eclampsia ✓✓ IV Magnesium sulfate to prevent
seizures and antihypertensives


Severe pre-clampsia requires immediate hospitalization when ✓✓
Sudden onset
BP >160/110
Proteinuria (>5 g in 24 hrs)
Oliguria (<400 mL in 24 hrs)
Cerebral and visual disturbances
Rapid weight gain
Treated aggressively
Serious threat to mom and baby




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, Nursing Intervention for severe preeclampsia includes ✓✓
Complete bed rest
Left lateral position
Dark/quiet room
High protein diet
8-10 glasses water day
Monitor I&Os every hour
administer fluid and electrolyte replacements as ordered
Assess for S/S of PE (crackles, wheezes, dyspnea, decreased O2 sat
levels, cough, cough neck vein distention, anxiety, and restlessness)
Same for HELLP


Women with severe pre-clampsia in labor will get ✓✓ Oxytocin
(contractions) and mag sulfate (seizure prevention)
Vaginal birth preferred to C-section
PGE 2 gel to ripen cervix
Pediatrician and Neonatologist in delivery room


Mag sulfate doses ✓✓ Load dose 4-6 g/5 min
Maintenance dose 2 g/hr
Monitor for toxicity
With high doses watch for respiratory depression, hypocalcemia,
hypotonia
Assess DTR and clonus
Newborn may have respiratory depression, loss of reflexes, muscle
weakness, and neurological depression




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