MIDWIFERY I FINAL EXAM QUESTIONS AND DETAILED
ANSWERS|ALREADY GRADED A
How is chronic hypertension diagnosed? Correct Ans- HTN prior to
conception or prior to 20 weeks
Mild chronic HTN
Severe chronic HTN Correct Ans- >140/90
>160/110
Persists for at least 12 weeks postpartum
Baseline labs for chronic HTN
Medications? Correct Ans- CBC, LFTS, creatinine, protein/creatinine
ratio
Antihypertensives not recommended unless they were on something
before, labetolol is commonly used
Management of chronic HTN--when to see pt and tests to perform?
Patient education? What should they watch out for? Correct Ans- Visits
every 3 weeks
NST, BPP, growth US
Manage diet, salt intake, exercise
Visual changes, decreased fetal movement, manage BP at home and
report >140/90, new-onset headache that won't go away with tylenol,
,heart burn that won't go away with tums, edema above elbows/knees or
face
Complications of chronic HTN---what are they are at high risk for?
Correct Ans- High risk for: preterm labor, placental abruption, cesarean,
IUGR, oligohydramnios
When is a pt considered to have gestational htn?
Can she have proteinuria?
Does it resolve postpartum? Correct Ans- Has two separate readings
>140 systolic OR 90 diastolic (for the first time) at least 6 hours apart
AFTER 20 weeks gestation
No proteinuria
Resolves within 12 weeks postpartum
What labs to monitor for gestational HTN?
Management? what tests to run? Correct Ans- urine protein, platelets,
LFTs
Serial growth U/S, BP readings at home 2x
No medications are necessary
Watch for s/s of preeclampsia
1. Pathophysiology of preeclamspia
, 2. Mild preeclamspia defined as?
3. Severe preeclampsia defined as?
4. When does preeclampsia usually occur? Correct Ans- 1. Abnormal
trophoblastic invasion of the uterus at the placental site
Causes narrowing of spiral arteries
2. 2 separate readings at least 6 hrs apart >140 OR >90 after 20 weeks
OR
Protein--> +300mg in 24 hr urine OR PCR 0.3 OR +1 urine dip on two
samples at least 6 hrs apart
3. 2 separate readings at least 6 hrs apart >160 OR >110 after 20 weeks
Protein-->+500mg in 24 hr urine OR +3 urine dip on two samples 6hrs
apart
4. Usually occurs late onset, >36 weeks
Diagnostic evaluation for preeclampsia
Severe features defined as? Correct Ans- HTN after 20 weeks greater
than 140/90 AND ONE of the following:
Proteinuria Greater than 300 in 24 hour urine
PCR >0.3
Greater than 1+ dipstick
Visual or cerebral symptoms
Platelets <100,000
ANSWERS|ALREADY GRADED A
How is chronic hypertension diagnosed? Correct Ans- HTN prior to
conception or prior to 20 weeks
Mild chronic HTN
Severe chronic HTN Correct Ans- >140/90
>160/110
Persists for at least 12 weeks postpartum
Baseline labs for chronic HTN
Medications? Correct Ans- CBC, LFTS, creatinine, protein/creatinine
ratio
Antihypertensives not recommended unless they were on something
before, labetolol is commonly used
Management of chronic HTN--when to see pt and tests to perform?
Patient education? What should they watch out for? Correct Ans- Visits
every 3 weeks
NST, BPP, growth US
Manage diet, salt intake, exercise
Visual changes, decreased fetal movement, manage BP at home and
report >140/90, new-onset headache that won't go away with tylenol,
,heart burn that won't go away with tums, edema above elbows/knees or
face
Complications of chronic HTN---what are they are at high risk for?
Correct Ans- High risk for: preterm labor, placental abruption, cesarean,
IUGR, oligohydramnios
When is a pt considered to have gestational htn?
Can she have proteinuria?
Does it resolve postpartum? Correct Ans- Has two separate readings
>140 systolic OR 90 diastolic (for the first time) at least 6 hours apart
AFTER 20 weeks gestation
No proteinuria
Resolves within 12 weeks postpartum
What labs to monitor for gestational HTN?
Management? what tests to run? Correct Ans- urine protein, platelets,
LFTs
Serial growth U/S, BP readings at home 2x
No medications are necessary
Watch for s/s of preeclampsia
1. Pathophysiology of preeclamspia
, 2. Mild preeclamspia defined as?
3. Severe preeclampsia defined as?
4. When does preeclampsia usually occur? Correct Ans- 1. Abnormal
trophoblastic invasion of the uterus at the placental site
Causes narrowing of spiral arteries
2. 2 separate readings at least 6 hrs apart >140 OR >90 after 20 weeks
OR
Protein--> +300mg in 24 hr urine OR PCR 0.3 OR +1 urine dip on two
samples at least 6 hrs apart
3. 2 separate readings at least 6 hrs apart >160 OR >110 after 20 weeks
Protein-->+500mg in 24 hr urine OR +3 urine dip on two samples 6hrs
apart
4. Usually occurs late onset, >36 weeks
Diagnostic evaluation for preeclampsia
Severe features defined as? Correct Ans- HTN after 20 weeks greater
than 140/90 AND ONE of the following:
Proteinuria Greater than 300 in 24 hour urine
PCR >0.3
Greater than 1+ dipstick
Visual or cerebral symptoms
Platelets <100,000
