Hypertensive Disorders in Pregnancy
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Questions and Answers

What is the term for hypertension that develops in late pregnancy without other findings or preeclampsia?

  • Transient hypertension of pregnancy
  • Gestational hypertension (correct)
  • Chronic hypertension
  • Preeclampsia

    • What is the definition of chronic hypertension in pregnancy?

  • BP ≥ 100/60 mmHg
  • BP ≥ 160/100 mmHg
  • BP ≥ 120/80 mmHg
  • BP ≥ 140/90 mmHg (correct)

    • What is the term for the coexistence of preeclampsia with preexisting chronic hypertension?

  • Gestational hypertension with superimposed preeclampsia
  • Chronic hypertension with superimposed preeclampsia (correct)
  • Preeclampsia with superimposed chronic hypertension
  • Transient hypertension with superimposed preeclampsia

    • What is a risk factor for preeclampsia?

    <p>Nulliparity</p> Signup and view all the answers

    What is the effect of decreased endothelial prostacyclin production in preeclampsia?

    <p>Diminished blood flow</p> Signup and view all the answers

    What is a systemic effect of preeclampsia?

    <p>Vital organs dysfunction</p> Signup and view all the answers

    What is a pregnancy effect of preeclampsia?

    <p>Intrauterine growth restriction</p> Signup and view all the answers

    What is the result of increased capillary permeability in preeclampsia?

    <p>Secrete toxic radicals/substances into the maternal circulation</p> Signup and view all the answers

    What is the definition of oligohydramnios?

    <p>Abnormally low volume of amniotic fluid</p> Signup and view all the answers

    What is the worldwide incidence of hypertensive disorders in pregnancy?

    <p>7-12%</p> Signup and view all the answers

    What is the primary characteristic of pregnancy-induced hypertension?

    <p>Hypertension associated with proteinuria and edema, occurring primarily after the 20th week or near term</p> Signup and view all the answers

    What is the definition of mild preeclampsia in terms of blood pressure?

    <p>BP ≥ 140/90mmHg</p> Signup and view all the answers

    What is the primary characteristic of severe preeclampsia in terms of proteinuria?

    <p>Dipstick 3+ or &gt;1-2 g/24-hr urine collection</p> Signup and view all the answers

    What is the occurrence of eclampsia in terms of the timing of onset?

    <p>25% occurring in the 1st 72 hs postpartum</p> Signup and view all the answers

    What is the primary characteristic of gestational hypertension?

    <p>Hypertension without proteinuria and edema, occurring primarily after the 20th week or near term</p> Signup and view all the answers

    What is the primary characteristic of chronic hypertension preceding pregnancy?

    <p>Hypertension without proteinuria and edema, occurring before pregnancy</p> Signup and view all the answers

    What is the primary characteristic of chronic hypertension with superimposed PIH?

    <p>Hypertension associated with proteinuria and edema, occurring primarily during the 3rd trimester, with superimposed preeclampsia</p> Signup and view all the answers

    What is the primary maternal effect of hypertensive disorders in pregnancy?

    <p>All of the above</p> Signup and view all the answers

    What is the recommended dosage of magnesium sulfate for a continuous infusion?

    <p>2g/hr</p> Signup and view all the answers

    What is a common side effect of magnesium sulfate?

    <p>Flushing</p> Signup and view all the answers

    What is a severe adverse effect of magnesium sulfate?

    <p>Muscle paralysis</p> Signup and view all the answers

    What should be assessed every hour when administering magnesium sulfate?

    <p>RR, UO, DTR, and clonus</p> Signup and view all the answers

    What is the recommended management for magnesium sulfate toxicity?

    <p>All of the above</p> Signup and view all the answers

    What is the antihypertensive medication used to decrease hypertension?

    <p>Hydralazine</p> Signup and view all the answers

    What is the recommended dosage of hydralazine?

    <p>5-10 mg/IV</p> Signup and view all the answers

    What is a risk for maternal injury related to pregnancy-induced hypertension?

    <p>Risk for maternal injury: ineffective tissue perfusion</p> Signup and view all the answers

    What is a recommended method of home management to prevent maternal and fetal risks?

    <p>Bed rest</p> Signup and view all the answers

    What is the abbreviation HELLP syndrome stands for?

    <p>Hemolysis, Elevated Liver enzymes, Low Platelet count</p> Signup and view all the answers

    Which of the following is a laboratory finding in HELLP syndrome?

    <p>Elevated LDH and decreased coagulation factors</p> Signup and view all the answers

    What is the primary goal of administering hydralazine in the management of hypertension in pregnancy?

    <p>To maintain diastolic pressure over 90 mmHg</p> Signup and view all the answers

    What is the loading dose of MgSO4 in the management of preeclampsia?

    <p>4-6 g IV</p> Signup and view all the answers

    What is the recommended rate of administration of hydralazine in the management of hypertension in pregnancy?

    <p>Administer slowly to avoid sudden fall in blood pressure</p> Signup and view all the answers

    What is the primary function of FHR monitoring in the management of preeclampsia?

    <p>To monitor fetal heart rate</p> Signup and view all the answers

    What is the common complication associated with HELLP syndrome?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of the non-stress test in the management of preeclampsia?

    <p>To assess fetal well-being</p> Signup and view all the answers

    What is the recommended dosage of hydralazine in the management of hypertension in pregnancy?

    <p>5-10 mg/IV</p> Signup and view all the answers

    What is the primary purpose of instructing a client with preeclampsia to monitor her daily weight?

    <p>To assess blood concentration</p> Signup and view all the answers

    What is the primary goal of restricting visitors and darkening the room for a client with preeclampsia?

    <p>To prevent seizure from occurring</p> Signup and view all the answers

    What is the purpose of administering magnesium sulfate to a client with preeclampsia?

    <p>To prevent eclampsia</p> Signup and view all the answers

    Why is it essential to raise the side rails of a client's bed with preeclampsia?

    <p>To prevent injury in case a seizure episode occurs</p> Signup and view all the answers

    What is the primary purpose of monitoring blood pressure every hour to four hours in a client with preeclampsia?

    <p>To detect any increase in blood pressure</p> Signup and view all the answers

    What is the purpose of obtaining blood studies as ordered in a client with preeclampsia?

    <p>To assess renal and liver function</p> Signup and view all the answers

    What is the primary purpose of daily self-monitoring of blood pressure in a client with preeclampsia?

    <p>To detect any increase in blood pressure</p> Signup and view all the answers

    What is the purpose of administering antihypertensive therapy to a client with preeclampsia?

    <p>To control maternal blood pressure</p> Signup and view all the answers

    What is the primary purpose of health education in a client with preeclampsia?

    <p>To provide information about the condition and self-care</p> Signup and view all the answers

    Study Notes

    Hypertensive Disorders in Pregnancy

    Types of Hypertensive Disorders

    • Pregnancy-induced hypertension:
      • Mild preeclampsia: BP ≥ 140/90mmHg, proteinuria (dipstick 1+ to 2+ or ≥ 300mg/24-hr urine collection), and weight gain ≥ 2 lbs/week (2nd trimester) or 1 lb/week (3rd trimester)
      • Severe preeclampsia: BP ≥ 160/110mmHg, marked proteinuria (3+ or more or >1-2g/24-hr urine collection), and at least one of the following symptoms: cerebral/visual disturbances, epigastric pain, marked edema, oliguria, pulmonary edema, or cyanosis
      • Eclampsia: preeclampsia with convulsions
    • Gestational hypertension: hypertension in late pregnancy without other findings or preeclampsia
    • Chronic hypertension preceding pregnancy: BP ≥ 140/90mmHg before 12 weeks postpartum
    • Chronic hypertension with superimposed preeclampsia or eclampsia: coexistence of preeclampsia or eclampsia with preexisting chronic hypertension

    Etiology and Pathophysiology

    • Decreased endothelial prostacyclin production
    • Increased thromboxane A2 secretion by activated platelets
    • Increased sensitivity to infused angiotensin II
    • Systematic vasoconstriction → resistance and subsequent hypertension
    • Diminished blood flow → vital organ dysfunctions, necrosis, and hemorrhage

    Maternal and Fetal Effects

    • Risk of placental abruption
    • Risk of preterm delivery
    • Intrauterine growth restriction (IUGR)
    • Oligohydramnios
    • Systemic effects: vital organ dysfunction, HELLP syndrome, DIC, seizures

    Investigation

    • Blood tests: elevated Hb or Hct, FDP, liver function, renal function
    • Retinal check
    • Fetal movement counts (FMC)
    • Non-stress test
    • Biophysical profile
    • Sonographic estimated fetal weight

    Treatment

    • Antihypertensive medication: hydralazine, diazepam
    • Mgso4 to prevent eclampsia and reduce edema
    • Management of Mgso4 toxicity: slow i.v. 10% calcium gluconate, oxygen supplementation, cardiorespiratory support

    Nursing Management

    • Risk for maternal injury: ineffective tissue perfusion
    • Risk for fetal injury: reduced placental perfusion
    • Home management: bed rest, daily self-monitoring of blood pressure and body weight, health teaching, diet, and fluid intake
    • Support bed rest: restrict visitors, darken the room, raise side rails
    • Monitor maternal well-being: blood pressure, blood studies, hematocrit levels, and weight
    • Monitor fetal well-being: non-stress tests, biophysical profiles, and sonographic estimated fetal weight
    • Support a nutritious diet and administer fluids
    • Administer medications to maintain BP and prevent eclampsia
    • Provide health education and monitor tonic-clonic seizures

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    Hypertensive Disorders in Pregnancy PDF

    Description

    This quiz covers the definition, types, etiology, pathophysiology, signs and symptoms, maternal and fetal effects, investigation, and treatment of hypertensive disorders in pregnancy. Also, it discusses nursing management and incidence of this common and serious condition in obstetrics.

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