OB4 27 hyptertensive

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lrnino
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212713
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OB4 27 hyptertensive
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2013-04-11 18:30:05
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OB4 27 hyptertensive
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OB4 27 hyptertensive
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  1. when is gestational HTN detected? what week?
    20th
  2. what BP does the mother have to have 2 times, 6 hrs apart, but no more than 7 days apart to be diagnosed with preeclampsia?
    140/90
  3. if the mom has GTN, when does the BP return to normal? what if it doesn't? what is she most likely going to be diagnosed with?
    12 weeks post partum. chronic htn.
  4. if a pregs comes in with a constant 140/90 and has protein in the urine, what might she have?
    mild preeclampsia.
  5. what BP is severe preeclampsia?
    160/110
  6. mother has a BP os 170/115, abdominal pain, oliguria, what might she have?
    severe preeclampsia
  7. what does the protein on the urine dip read with someone with severe preeclampsia?
    >2
  8. does the pt suffer from oliguria with mild or severe preeclampsia?
    severe.
  9. what does the pt look like when she's moving from mild to severe preeclampsia?
    oliguria, pulmonary edema, cyanosis.
  10. what kind of pain are you expecting when you're assessing severe preelampsia?
    pain around their liver.
  11. what are some risk factors for preeclampsia?
    • diabetes
    • vascular disease
    • underlying renal disease
    • being black
  12. what are the definite causes of preeclampsia?
    causes are unknown.
  13. what is going on with the kidney, liver, CNS and heart in preeclampsia?
    • kidney - can't work properly so ^CA, impaired NA excretion
    • liver - hepatic rupture then necrosis, elevated enzymes bc not working properly. 
    • CNS - headaches. SEIZURES. convulsion. blurred vision.
    • Heart - not really affected unless really serious.
  14. what do you monitor in the mother with preeclampsia?
    • weekly labs
    • 24hr urine protein
    • corticosteroids for the baby
    • daily kick counts
    • ultrasound once or twice weekly
  15. what can the nurse expect to give to someone with severe preeclampsia?
    mag.
  16. the pt is presenting with severe preeclampsia and has orders to give mag. what SE are you supposed to look for?
    • mag is a CNS depressant. look for:
    • clonus
    • visual disturbances
    • head ache
    • facial twitching
  17. what does magnesium sulfate do to a pregs mother?
    relaxes smooth muscles. preventing seizures and contractions.
  18. what is the antidote for mag?
    calcium gluconate.
  19. what physical assessment are you doing/looking for when assessing a pt with mag?
    DTRs, edema, head, GI.
  20. what are some signs that you need immediate action towards with someone that's on mag?
    • loss of patellar function
    • <12 breaths/min
    • oliguria
    • decreased LOC
  21. what do you do with someone you know that has a mag toxicity?
    • turn off mag. 
    • call MD.
    • be ready with CA gluconate
    • give O2 if needed
    • call for stat ekg
    • call for stat mag level.
  22. about how much CA gluconate do you need to counter mag?
    ratio 1:1
  23. what's a common drug given to a mother that has eclampsia before or during labor when the mag isn't working?
    ativan
  24. what is HELLP syndrome?
    • this is worsening preeclampsia. 
    • Hemolysis of RBC
    • Elevated
    • Liver enzymes
    • Low
    • Platelets. 

    so blood feels like water. could bleed out.
  25. a mother is presenting with N/V, feeling "uneasy", RUQ/abdominal pain, shoulder pain, edema GI bleeding...what could she have?
    HELLP syndrome.
  26. how do you manage a mother in HELLP syndrome until she delivers?
    • stabilize her
    • anticipate blood products
    • anticipate delivery
    • anticipate CT or abdominals (might have hematoma)
    • Mag
  27. what is the difference between HTN and preeclampsia?
    the high BP came before the pregs and will not resolve after pregs.
  28. a mother is receiving methyldopa, what could it be for?
    HTN during pregs
  29. a mother is receiving labetalol, what could that be for?
    HTN during pregs
  30. a mother is receiving hydrazaline, why?
    mother has HTN
  31. a mother is receiving procardia, what for?
    HTN
  32. what are the causes for preeclampsia? are there tests i can take that will tell me for sure if i'm going to get it?
    the cause is unknown and there are no tests that tell for sure.
  33. what life threatening syndrome can severe preeclampsia lead to that we don't want our mothers to go into?
    HELLP syndrome.
  34. a pt is receiving mag for the HTN and early contractions, what are you monitoring closely?
    • respiratory rate (decreased)
    • DTR
    • urine output

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