answers rated A+
what are some psychosocial factors that increase risk in pregnancy? - ANS ✔Smoking
Caffeine
Alcohol and substance abuse
Maternal obesity
Inadequate support system
Situational crisis
History of violence
Emotional distress
Unsafe cultural practices
what are some environmental factors increase risk in pregnancy? - ANS ✔Infections
Radiation
,Pesticides
Illicit drug use
Industrial pollutants
Second-hand cigarette smoke
Personal stress
what are sociodemographic factors that contribute to high risk pregnancy - ANS ✔-poverty
status
-lack of prenatal care
-<15 yo and >35 yo
-parity: all first pregnancies and 5+ pregnancies
-marital status (single women more at risk)
-accessibility to healthcare
-ethnicity (increased risk on non-white women)`
what is the most common disorder to develope during pregnancy - ANS ✔hypertensive
disorders
,what is gestational hypertension (what are the SBP and DBP values) - ANS ✔>1490/90 mm Hg
occurring after 20 weeks gestation
(BP returns to normal by 12 wks postpartum)
what is preeclampsia: - ANS ✔Multisystem disorder when blood pressure is above 140/90 and
proteinuria (> 300 mg or more in 24 hrs) after 20th week of gestation.
what is ecclampsia - ANS ✔preeclampsia w/ the presence fo seizures
what is needed for the diagnoses of gestational hypertensive disorder to be made? - ANS
✔>140 mm Hg and/or DBP >90 mm Hg at two encounters at least 6 hours apart after 20 wks
gestation
what are the risk factors for preeclampsia? - ANS ✔High BMI, previous preeclampsia, multiple
gestations
Underlying medical conditions: diabetes, chronic HTN, renal disease, obesity
Family hx, african american ethnicity
Age: <19 yo and >40 yo
what are thought to be the underlying mechanisms of preeclampsia - ANS ✔Vasospasm and
hypo-perfusion
Endothelial injury causing platelet adherence, fibrin deposition, and fragmented erythrocytes
, what is the patient presentation of mild preeclampsia? - ANS ✔>140/90 mm Hg after 20 wks on
two occaisions at least 4 hours apart
300mg/24 hr or >1+ protein urine dip
Mild facial or hand edema
Weight gain
what is the result of the hypertensive state in preeclampsia/eclampsia - ANS ✔-increase
thromboxane (vasoconstrictor that stimulates platelet aggregation)
-decreased prostacyclin (potent vasodilator and inhibitor of platelet aggregation)
what are the fetal effects of preeclampsia/eclampsia? what is it caused by? (4) - ANS ✔poor
placental perfusion and prolonged vasoconstriction lead to IUGR, abruptio placentae, fetal
hypoxia and acidosis
what is the conservative treatment of gestational hypertension? - ANS ✔-bedrest
-left lateral side-lying position to reduce BP, increase blood flow to placenta, and promote
diuresis
-monitor s/s, CBC, clotting studies, liver enzymes, BUN, creatinine, uric acid, and proteinuria
during prenatal visits