Podcast
Questions and Answers
A pregnant woman presents with hypertension, proteinuria, and edema before 20 weeks of gestation. Which condition should the nurse suspect, considering the information provided?
A pregnant woman presents with hypertension, proteinuria, and edema before 20 weeks of gestation. Which condition should the nurse suspect, considering the information provided?
- HELLP syndrome
- Pregnancy-induced hypertension (PIH) (correct)
- Eclampsia
- Gestational hypertension
A pregnant woman at 28 weeks' gestation has a blood pressure of 150/95 mm Hg on two separate occasions, six hours apart. She also has a protein level of 1+ on a random urine sample. What condition is most consistent with these findings?
A pregnant woman at 28 weeks' gestation has a blood pressure of 150/95 mm Hg on two separate occasions, six hours apart. She also has a protein level of 1+ on a random urine sample. What condition is most consistent with these findings?
- Severe pre-eclampsia
- Gestational hypertension
- Mild pre-eclampsia (correct)
- Eclampsia
A pregnant woman with severe pre-eclampsia reports epigastric pain, nausea, and vomiting. What is the most likely underlying cause of these symptoms?
A pregnant woman with severe pre-eclampsia reports epigastric pain, nausea, and vomiting. What is the most likely underlying cause of these symptoms?
- Gastroesophageal reflux disease (GERD)
- Abdominal edema or pancreatic/liver ischemia (correct)
- Appendicitis
- Gallbladder disease
A pregnant woman with severe pre-eclampsia suddenly experiences a grand-mal seizure. Which condition has she most likely developed?
A pregnant woman with severe pre-eclampsia suddenly experiences a grand-mal seizure. Which condition has she most likely developed?
A pregnant woman with mild pre-eclampsia is being managed at home. Which of the following nursing interventions is most appropriate?
A pregnant woman with mild pre-eclampsia is being managed at home. Which of the following nursing interventions is most appropriate?
For a woman with mild PIH, what position is optimal for promoting diuresis and reducing uterine pressure on the vena cava during bed rest?
For a woman with mild PIH, what position is optimal for promoting diuresis and reducing uterine pressure on the vena cava during bed rest?
A pregnant woman at 34 weeks' gestation is diagnosed with severe pre-eclampsia. Her blood pressure is consistently above 160/110 mm Hg despite bed rest. What is the PRIORITY nursing intervention based on this information?
A pregnant woman at 34 weeks' gestation is diagnosed with severe pre-eclampsia. Her blood pressure is consistently above 160/110 mm Hg despite bed rest. What is the PRIORITY nursing intervention based on this information?
A patient with severe pre-eclampsia is receiving magnesium sulfate. Which assessment finding requires immediate intervention?
A patient with severe pre-eclampsia is receiving magnesium sulfate. Which assessment finding requires immediate intervention?
During magnesium sulfate administration for severe pre-eclampsia, which deep tendon reflex is typically assessed, and where is it located?
During magnesium sulfate administration for severe pre-eclampsia, which deep tendon reflex is typically assessed, and where is it located?
A patient receiving magnesium sulfate for severe pre-eclampsia exhibits signs of magnesium toxicity. Which medication should the nurse prepare to administer?
A patient receiving magnesium sulfate for severe pre-eclampsia exhibits signs of magnesium toxicity. Which medication should the nurse prepare to administer?
Why should the diastolic blood pressure of a woman with severe PIH not be lowered below 80 to 90 mm Hg?
Why should the diastolic blood pressure of a woman with severe PIH not be lowered below 80 to 90 mm Hg?
A woman with severe pre-eclampsia has oliguria. Which intravenous solution might be administered to help promote fluid excretion?
A woman with severe pre-eclampsia has oliguria. Which intravenous solution might be administered to help promote fluid excretion?
A pregnant woman with PIH suddenly reports blurred vision and seeing spots. Which condition should the nurse suspect?
A pregnant woman with PIH suddenly reports blurred vision and seeing spots. Which condition should the nurse suspect?
A pregnant patient at 30 weeks gestation is diagnosed with severe pre-eclampsia. Her blood pressure is 165/115 mmHg, and she exhibits 4+ proteinuria. Which of the following findings would be most concerning and indicative of impending eclampsia?
A pregnant patient at 30 weeks gestation is diagnosed with severe pre-eclampsia. Her blood pressure is 165/115 mmHg, and she exhibits 4+ proteinuria. Which of the following findings would be most concerning and indicative of impending eclampsia?
A nurse is caring for a patient with severe pre-eclampsia receiving magnesium sulfate. The patient's respiratory rate decreases to 10 breaths per minute. What is the nurse's most appropriate initial action?
A nurse is caring for a patient with severe pre-eclampsia receiving magnesium sulfate. The patient's respiratory rate decreases to 10 breaths per minute. What is the nurse's most appropriate initial action?
Flashcards
Pregnancy-Induced Hypertension (PIH)
Pregnancy-Induced Hypertension (PIH)
Vasospasm during pregnancy in both small and large arteries, possibly linked to antiphospholipid antibodies.
Signs of PIH
Signs of PIH
Hypertension, proteinuria, and edema.
Mild Pre-eclampsia
Mild Pre-eclampsia
Blood pressure rises to 140/90 mm Hg with proteinuria.
Severe Pre-eclampsia
Severe Pre-eclampsia
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Eclampsia
Eclampsia
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Antipletlet Therapy
Antipletlet Therapy
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Promote Bed Rest
Promote Bed Rest
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DOC to prevent eclampsia.
DOC to prevent eclampsia.
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Assessing Deep Tendon Reflexes
Assessing Deep Tendon Reflexes
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Antidote for Magnesium Toxicity
Antidote for Magnesium Toxicity
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Study Notes
- Pregnancy-induced hypertension (PIH) involves vasospasm in both small and large arteries during pregnancy.
- The cause of PIH is unknown, but it is highly correlated with antiphospholipid syndrome or the presence of antiphospholipid antibodies.
- Hypertension, proteinuria, and edema are signs of PIH.
- Instruct patients to contact a healthcare facility at the onset of unusual symptoms.
Mild Pre-eclampsia
- It lies above gestational hypertension but below the point of seizures
- Proteinuria and blood pressure readings of 140/90 mm Hg or higher, confirmed on two occasions at least 6 hours apart, are indicative of mild pre-eclampsia.
- Diastolic pressure indicates the degree of peripheral arterial spasm.
- Systolic blood pressure exceeding 30 mm Hg or diastolic pressure exceeding 15 mm Hg above pre-pregnancy values.
- Proteinuria is present, indicated by 1 or 2 on a reagent test strip using a random sample.
- Orthostatic proteinuria may occur, positive with standing and negative with bed rest.
Severe Pre-eclampsia
- Blood pressure rises to 160/110 mm Hg or higher, confirmed on two occasions 6 hours apart with the patient on bed rest.
- Presence of marked proteinuria, indicated by a reading of 3 or 4 on a random urine sample, or exceeding 5 g in a 24-hour sample, accompanied by extensive edema.
- Some individuals experience severe epigastric pain, nausea, and vomiting.
- Pulmonary edema leads to shortness of breathing.
- Cerebral edema causes blurred vision or presence of spots, severe headache, hyperreflexia, and potential ankle clonus.
Eclampsia
- This is the most severe form of PIH.
- Cerebral edema leads to grand-mal seizures (tonic-clonic) or coma.
- Maternal mortality rate is approximately 20% due to cerebral hemorrhage, circulatory collapse, or renal failure.
- Fetal prognosis is poor due to hypoxia and fetal acidosis, which is worsened by placental separation due to vasospasm.
Nursing Interventions for Mild PIH
- Mild PIH can be managed at home with continuous follow ups.
- Monitor antiplatelet therapy, such as low-dose aspirin (50–150 mg) to prevent maternal bleeding, should be ensured to prevent complications during birth.
- Encourage bed rest to aid sodium evacuation and promote diuresis, recommend the lateral recumbent position to avoid uterine pressure on the vena cava.
Nursing Interventions for Severe PIH
- Hospital confinement is necessary in the presence of BP at or exceeding 160/110 mmHg (on bed rest), extensive edema, marked proteinuria [3 to 4], cerebral or visual disturbances, marked hyperreflexia and oliguria (500 mL per 24 hours or less).
- Induction of labor and CS operation is implemented at 36 weeks AOG with confirmed fetal lung maturity (via amniocentesis).
- Diastolic pressure should be maintained above 80 to 90 mm Hg to ensure adequate placental perfusion.
- Magnesium Sulfate is the DOC to prevent eclampsia.
- Magnesium Sulfate acts as a cathartic, which reduces edema, and as a CNS depressant, preventing seizures.
- The patellar reflex (knee jerk) is the easiest deep tendon reflex to assess.
- In the case of epidural block for labor anesthesia, assess the biceps or triceps reflex.
- A 10% calcium gluconate solution (1 g in 10 mL) should be available for immediate intravenous administration in the event of magnesium toxicity.
- Salt-poor albumin may be administered intravenously to treat severe oliguria.
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