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Questions and Answers
What is the most appropriate action to take given Harriet's current blood pressure of 140/90?
How do Harriet's current platelet count of 150 x 10^5 mmol/l and urate level of 34 mmol/l relate to her pregnancy?
Which statement about pre-eclampsia is correct?
What should you communicate to Harriet about her health concerns?
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Given Harriet's booking blood pressure of 130/70, what does the increase to 140/90 likely indicate?
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What does the change in Harriet's platelet count suggest in terms of her overall condition?
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How should a midwife approach a pregnant patient presenting with elevated blood pressure?
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Which risk factor is associated with pre-eclampsia worsening?
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What is the primary underlying mechanism suspected in pre-eclampsia?
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Which of the following conditions is associated with pre-eclampsia?
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Which observation regarding Harriet would be most concerning in relation to pre-eclampsia?
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Which assessment is least appropriate for monitoring Harriet's condition?
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What is a common potential effect of pre-eclampsia on an infant's growth?
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After a Caesarean birth, is Harriet still at risk for eclampsia?
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Which statement about severe pre-eclampsia is false?
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What is a common characteristic symptom of pre-eclampsia?
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Study Notes
Blood Pressure and Midwifery Actions
- Harriet's initial blood pressure was 130/70; current measurement is 140/90.
- Recommended action includes retaking blood pressure, conducting a full assessment, urinalysis, and sending off blood tests.
- Immediate referral to a consultant obstetrician is not deemed necessary at this stage.
Hematological Changes
- Harriet's initial platelet count was 350 x 10^5 µl; reduced to 150 x 10^5 µl.
- Urate levels are at 34 mmol/l.
- Results indicate serious hematological changes, suggesting possible preeclampsia, warranting a referral.
Pre-eclampsia Characteristics
- More severe risk when it begins in the second trimester and is likely to lead to HELLP syndrome starting at 26 weeks.
- Pre-eclampsia is a multi-system disorder linked to autoimmune responses in pregnancy and imbalances in placental blood flow.
Patient Communication
- Concerns about Harriet's blood pressure and blood changes should be communicated clearly, suggesting assessment by an Obstetrician.
- It's not just a routine check; reassurance without addressing concerns could be misleading.
Assessment of Pre-eclampsia and Associations
- Pre-eclampsia is associated with abnormal placental development affecting blood vessel formation.
- Relevant medical conditions linked to pre-eclampsia include abruptio placenta rather than placenta accrete or vasa praevia.
Symptoms and Risks
- Jitteriness and facial edema in Harriet indicate potential worsening of her condition, signifying a possible risk of an eclamptic fit.
- Regular assessments including biophysical profiles and full blood counts are crucial for monitoring her condition.
Effects on Fetal Development
- Harriet's condition could likely result in her baby being small for gestational age due to intrauterine growth restriction (IUGR) and risks associated with pre-term birth.
- Continuous monitoring of fetal growth and wellbeing is essential.
Postnatal Eclampsia Risks
- The risk of eclampsia remains high during the first week postpartum, notably within the first 48 hours, despite delivery.
- Medical team intervention is necessary in managing hypertension during and post-surgery.
False Statement Detection
- Among the listed outcomes of severe pre-eclampsia, all conditions mentioned (abnormal liver enzymes, cholestasis, epigastric pain) can occur. None of these can be considered false, ensuring emphasis on possible severe implications such as HELLP syndrome.
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Description
This quiz focuses on midwifery actions related to blood pressure monitoring and hematological changes in pregnant patients, specifically addressing pre-eclampsia. It includes patient assessment techniques, possible complications, and effective communication strategies regarding patient health. Understand key indicators and necessary referrals for optimal patient care.
