106 Final: Preeclampsia and Magnesium Sulfate

Questions and Answers

Preeclampsia is a disorder encountered most often when?

in the last 20 weeks of gestation, during labor, or in the first 12-48 hours after delivery

Preeclampsia is characterized by one or more of what signs?

hypertension, edema, albuminuria, and in severe cases, convulsion and coma

When chronic hypertensive vascular disease is noted before the last 20 weeks of pregnancy and persists indefinitely afterwards, the patient does not have what?

preeclampsia

Although the cause of preeclampsia is not known, it is felt that the process involves an increased responsiveness to what?

the vasopressor, angiotensin II Signup and view all the answers

An increase in both systolic and diastolic pressures in a patient with preeclampsia is due to what?

vasospasm Signup and view all the answers

As this process of preeclampsia occurs in other parts of the body, the symptoms of what will appear?

albuminuria and edema Signup and view all the answers

When ischemia and infarction of the renal cortical tissue occurs, the symptoms of what will present?

proteinuria Signup and view all the answers

The presence of what accounts for sudden increased weight gain in patients with preeclampsia?

edema Signup and view all the answers

What are the three classifications that preeclampsia can be divided into?

mild pre-eclampsia, severe pre-eclampsia, and eclampsia Signup and view all the answers

The severity of the 3 primary symptoms of preeclampsia are?

edema, proteinuria, hypertension Signup and view all the answers

A patient having a BP ranging from 140/90 or more would be classified as having what?

mild pre-eclampsia Signup and view all the answers

Whereas, a patient having a blood pressure greater than 160/100 would be classified as having what?

severe pre-eclampsia Signup and view all the answers

We should expect to find little or no peripheral edema in what type of preeclampsia?

mild preeclampsia Signup and view all the answers

Facial, hand, and possibly pulmonary edema may be present in what type of preeclampsia?

severe preeclampsia Signup and view all the answers

An albuminuria of 1+ or 2+ may signify what?

mild preeclampsia Signup and view all the answers

Whereas albuminuria of 3+ or 4+ and oliguria may indicate what type of preeclampsia?

severe preeclampsia Signup and view all the answers

The 3 symptoms one might expect to find in a patient diagnosed as having mild preeclampsia are what?

140/90 BP or more, 1+ or 2+ albuminuria, little or no peripheral edema Signup and view all the answers

What are the 3 symptoms one might expect to find in a patient diagnosed as having severe preeclampsia?

160/100 BP, 3+ or 4+ albuminuria and oliguria, facial and hand edema Signup and view all the answers

A person with severe preeclampsia may also experience what?

severe frontal headache, epigastric pain, visual disturbances, severe nausea and vomiting Signup and view all the answers

Vasospasm of the retinal vessels together with ischemia and edema are responsible for what?

visual disturbances Signup and view all the answers

The process of vasoconstriction, hypertension, and fluid retention occurring in the area of the cerebrum probably accounts for what?

the frontal headache Signup and view all the answers

While congestion and necrosis in the sinusoids of the liver may be indicated by the presence of what?

epigastric pain Signup and view all the answers

Clonus is what and can be checked how?

alternate involuntary muscular contraction and relaxation in rapid succession; can be checked by extending her leg and pushing the foot forward and releasing it Signup and view all the answers

What is often the sign of impending convulsion (then eclampsia) caused by increased vascular engorgement?

not provided Signup and view all the answers

Study Notes

Preeclampsia Overview

Preeclampsia typically occurs in the last 20 weeks of pregnancy, during labor, or within the first 12-48 hours postpartum.
Characterized by hypertension, edema, albuminuria (protein in urine), and potentially convulsions or coma in severe cases.

Diagnosis Criteria

Patients with chronic hypertension prior to 20 weeks of pregnancy do not have preeclampsia if it persists indefinitely.
Increased sensitivity to the vasopressor angiotensin II may contribute to edema, ischemia, and necrosis.
Blood pressure in preeclampsia can rise due to vasospasm, with nutritional factors potentially influencing risk.

Symptoms and Classification

Symptoms include albuminuria and edema as ischemia and infarction occur in the body.
Sudden weight gain (5-10 pounds weekly) in preeclampsia is attributed to edema.

Classifications of Preeclampsia

Preeclampsia is classified into mild pre-eclampsia, severe pre-eclampsia, and eclampsia.
Primary symptoms for classification include:
- Edema
- Albuminuria
- Hypertension

Blood Pressure Measurements

Mild pre-eclampsia is indicated by blood pressure ranging from 140/90 or more, or an increase of at least 30 mm Hg systolic and 15 mm Hg diastolic above baseline.
Severe pre-eclampsia is defined by blood pressure greater than 160/100.

Edema Characteristics

Mild preeclampsia typically exhibits little to no peripheral edema.
Severe preeclampsia may present facial, hand, and possibly pulmonary edema.

Albuminuria Levels

Mild preeclampsia may show albuminuria of 1+ or 2+.
Severe preeclampsia is indicated by albuminuria of 3+ or 4+ with oliguria (reduced urine output).

Symptoms Distinction

Expected symptoms for mild preeclampsia:
- Blood pressure of 140/90 or more
- 1+ or 2+ albuminuria
- Little to no peripheral edema
Expected symptoms for severe preeclampsia:
- Blood pressure of 160/100
- 3+ or 4+ albuminuria and oliguria
- Facial and hand edema

Additional Symptoms of Severe Preeclampsia

Severe frontal headache, often preceded by upper right quadrant pain before seizures.
Epigastric pain indicating liver congestion and necrosis.
Visual disturbances, including blurred vision and scotomata.
Severe nausea and vomiting.

Specific Complications

Vasospasm of retinal vessels causes visual disturbances.
Frontal headaches likely result from vasoconstriction and fluid retention in the cerebrum.
The presence of epigastric pain may signify liver issues.

Clonus Assessment

Clonus refers to involuntary muscular contractions and can be assessed by extending the leg and applying pressure on the foot, then releasing it to observe “toes wobbling.”

Impending Convulsion Indicators

Clonus is considered a sign of impending convulsion, leading to eclampsia, often due to increased vascular engorgement.

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Description

Test your knowledge on the definitions and classifications of preeclampsia and the use of magnesium sulfate. This flashcard set covers key concepts such as symptoms and timing during pregnancy. Ideal for nursing or medical students preparing for exams.