N4341 - Exam 2 (OB - Hoolapa,Welch) questions with answers

N4341 - Exam 2 (OB - Hoolapa/Welch) |\ |\ |\ |\ |\ |\ |\




questions with answers |\ |\




What BP during pregnancy is considered hypertensive?
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Severe hypertension? |\




>140/90
severe: >160/110 |\




Qualifications for chronic HTN during pregnancy (2) |\ |\ |\ |\ |\ |\




HTN before 20 weeks
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OR
lasting >12 weeks after PP
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What are the types of hypertensive disorders associated with
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pregnancy? (5) |\




gestational HTN (no protein in urine) |\ |\ |\ |\ |\


preeclampsia (protein in urine) |\ |\ |\


eclampsia (pre-e w/ seizures) |\ |\ |\


HELLP (hemolysis of RBC, elevated liver enzyme, low platelets)
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chronic HTN with superimposed preeclampsia
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Risk factors for hypertensive disorders during pregnancy (6)
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first child w/ new partner
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hydatidiform mole |\


diabetes
multiple gestation (twins) |\ |\


primigravida
age extremes of <17 or >40
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Discuss the scoring of fetal station
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,-4 = floating
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0 = at ischial spines
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+4 = crowning
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Define when gestational HTN occurs |\ |\ |\ |\




after 20 weeks |\ |\


OR
within first 24h after delivery w/out protein in urine
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To be considered hypertensive, blood pressure must be _____ on
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____ occasions at least _____ apart.
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BP >140/90 on 2 separate occasions at least 6 hours apart
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When is gestational HTN expected to return to normal?
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Otherwise what? |\




BP will return to normal ~12 weeks after delivery
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otherwise it's now chronic HTN |\ |\ |\ |\




What are the defining characteristics of preeclampsia? (2)
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proteinuria of +1 on dipstick OR >300mg in 24hr urine |\ |\ |\ |\ |\ |\ |\ |\ |\


edema of face, hands, sacrum |\ |\ |\ |\




Complications of preeclampsia to mother (7) |\ |\ |\ |\ |\




pulmonary edema |\


oliguria
thrombocytopenia
headaches
hyperreflexia
blurred vision |\


seizures
Pregnant mother with preeclampsia is complaining of right upper
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quadrant pain, what do you suspect? |\ |\ |\ |\ |\




liver involvement from pre-e
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, How does preeclampsia affect fetal heart rate? (2)
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*pre-e reduces placental perfusion* |\ |\ |\


late decels |\


↓ variability
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Effects of pre-e on fetus (3) |\ |\ |\ |\ |\




IUGR
fetal hypoxia (AEB late decels and ↓ variability)
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oligohydramnios (<500) |\




Why would glucocorticoids be prescribed for a pre-e mom?
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for fetal lung maturity (in case delivers preterm) given to ↑
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surfactant production in fetus |\ |\ |\


*takes ~48h to kick in, must repeat q 7 days
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What is the average fluid restriction to manage pre-e?
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125 mL/hr |\




What is the MOA of MgSO₄? (2) |\ |\ |\ |\ |\ |\


What does each MOA result in? |\ |\ |\ |\ |\




↓CNS excitability ∴ seizure prevention
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smooth muscle relaxer ∴ ↓BP (watch it doesn't go too low!)
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Note regarding using pitocin with magnesium (2)
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pitocin does NOT ↑BP |\ |\ |\



will need to use more pitocin to induce ctx ∵ mag being a smooth
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muscle relaxer
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MgSO₄ should be used cautiously if patient has what type of
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preexisting condition? |\




renal impairment |\




Patient with pre-e now experiences a seizure, this is now
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classified as ________. What will you prepare for? |\ |\ |\ |\ |\ |\ |\