Pathophysiology of Hypertension in Pregnancy
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Questions and Answers

What is a common symptom of magnesium toxicity?

  • Normalized blood pressure
  • Loss of deep tendon reflexes (correct)
  • Increased oxygen saturation
  • Increased urine output

    • Why is it important to educate the client on IV magnesium?

  • To manage initial feelings of flush, heat, nausea, and burning at the IV site (correct)
  • To reduce the risk of kidney issues
  • To promote seizure activity
  • To prevent placenta abruption

    • What is a common requirement for patients receiving IV magnesium?

  • Restrictive fluid intake
  • Continuous pulse oximetry (correct)
  • Frequent blood draws
  • Immobility

    • What is the primary reason for seizure precautions in postpartum care?

    <p>To manage magnesium toxicity</p> Signup and view all the answers

    What is the recommended dosage of calcium gluconate for treating magnesium toxicity?

    <p>4g loading dose</p> Signup and view all the answers

    What is a characteristic of an anterior placenta previa?

    <p>It won't affect fetal movement</p> Signup and view all the answers

    What is a primary goal of discharge teaching in postpartum care?

    <p>To educate on physiological adaptations during the postpartum period</p> Signup and view all the answers

    What is a characteristic of a complete placenta previa?

    <p>It covers the cervix</p> Signup and view all the answers

    Why may women with episiotomy, lacerations, or hemorrhoids delay bowel movement?

    <p>Fear of increasing pain or tearing stitches</p> Signup and view all the answers

    What is the consequence of refusing or delaying bowel movement?

    <p>Increased constipation and pain</p> Signup and view all the answers

    What is the significance of the first 6-8 hours after delivery in relation to urinary elimination?

    <p>Catheterization should be considered if unable to void</p> Signup and view all the answers

    What occurs in the first 2-5 days after delivery to rid the body of extra fluid?

    <p>Diuresis occurs</p> Signup and view all the answers

    What is a possible indication of dehydration in the first 24 hours after delivery?

    <p>Elevation of temperature above 100.4</p> Signup and view all the answers

    What is a possible indication of postpartum hypertension?

    <p>Significant increase in blood pressure</p> Signup and view all the answers

    Why is it essential to assess for Homans sign after delivery?

    <p>Due to elevated clotting factors</p> Signup and view all the answers

    What is the average blood loss during vaginal birth?

    <p>500ml</p> Signup and view all the answers

    What is the typical duration before menstruation resumes for postpartum women?

    <p>Typically by 12 weeks</p> Signup and view all the answers

    What sign is present in less than one-third of patients with confirmed DVT?

    <p>Homan's sign</p> Signup and view all the answers

    What is a common practice for mothers who are not breastfeeding?

    <p>Wear a supportive bra</p> Signup and view all the answers

    When is the optimal time to initiate breastfeeding?

    <p>Within the first hour of birth</p> Signup and view all the answers

    What indicates effective breastfeeding?

    <p>Breast will soften</p> Signup and view all the answers

    What are common benefits of breastfeeding for the newborn?

    <p>Enhanced immunity</p> Signup and view all the answers

    How long is the recommended feeding duration for each session?

    <p>30-40 minutes</p> Signup and view all the answers

    What is a common risk associated with irregular menstruation in postpartum women?

    <p>Increased chance of getting pregnant</p> Signup and view all the answers

    What primary monitoring method is suggested for assessing skin temperature in relation to perfusion?

    <p>Observing the temperature of the skin</p> Signup and view all the answers

    Which condition is NOT associated with gestational hypertensive diseases?

    <p>Chronic hypertension</p> Signup and view all the answers

    What is the underlying mechanism contributing to poor tissue perfusion in hypertensive disorders of pregnancy?

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

    Which of the following is considered the only cure for hypertensive disorders in pregnancy?

    <p>Delivery of the placenta</p> Signup and view all the answers

    Which vital sign can provide information on the adequacy of perfusion aside from skin temperature?

    <p>Blood pressure</p> Signup and view all the answers

    Which of the following skin observations indicates possible poor perfusion?

    <p>Pallor and cyanosis</p> Signup and view all the answers

    What is a key sign that indicates a newborn is being fed adequately?

    <p>6-8 wet diapers per day</p> Signup and view all the answers

    What condition occurs due to skipping feedings when nipples are sore?

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

    What is an appropriate nutritional recommendation for a breastfeeding mother?

    <p>Increase caloric intake</p> Signup and view all the answers

    What psychological response may a mother experience in the first couple of days postpartum?

    <p>Passive behavior and focus on personal needs</p> Signup and view all the answers

    What is the recommended practice for mothers who are not breastfeeding?

    <p>Wear a well-fitting bra</p> Signup and view all the answers

    What is a potential risk factor for Sudden Infant Death Syndrome (SIDS)?

    <p>Soft mattress and loose bedding</p> Signup and view all the answers

    What is an important physical adaptation for a mother during the postpartum period?

    <p>Establishing a routine that includes the newborn</p> Signup and view all the answers

    What is a common behavior of a postpartum adolescent mother?

    <p>Struggling with the transition to motherhood</p> Signup and view all the answers

    What is one of the methods to potentially prevent SIDS?

    <p>Ensuring a firm sleeping surface</p> Signup and view all the answers

    What is one way to support culturally diverse practices in postpartum care?

    <p>Include female relatives in teaching sessions</p> Signup and view all the answers

    Study Notes

    Monitoring and Assessment

    • Skin temperature observation is crucial for assessing capillary perfusion.
    • Urine output serves as an important indicator of tissue perfusion adequacy.
    • Abnormal blood pressure readings are significant for diagnosing hypertensive disorders.
    • Pulse oximetry assesses oxygen uptake and delivery; low levels signify reduced oxygen availability.
    • Observe for symptoms such as pallor, cyanosis, mottling, and cool or clammy skin.

    Hypertensive Disorders in Pregnancy

    • Hypertensive diseases during pregnancy are classified based on organ effects.
    • Vasospasm leads to poor tissue perfusion and manifests in various hypertensive disorders.
    • Gestational hypertension and chronic hypertension may co-occur.
    • Associated risks include placental abruption, kidney failure, liver failure, preterm birth, and mortality for mother and fetus.
    • Hypertensive disorders are the second leading cause of maternal deaths, following hemorrhage.

    Magnesium Toxicity Monitoring

    • Signs include loss of deep tendon reflexes, shortness of breath, oliguria, and decreased oxygen saturation.
    • Initial side effects of IV magnesium include feelings of flush, heat, nausea, and burning at the IV site.
    • A calm, quiet environment is necessary for patient well-being; avoid distressing situations.
    • Follow a clear liquid diet and observe seizure precautions.
    • Continuous pulse oximetry is essential for monitoring.

    Postpartum Care

    • Discharge education should start at admission; significant information delivery is necessary.
    • Address postpartum discomforts and changes in body image; prioritize food and sleep for new mothers.
    • Be aware of potential constipation; early ambulation and stool softeners may alleviate discomfort.

    Urinary System Changes

    • Watch for swelling and bruising around the urethra to prevent overdistention.
    • Diuresis typically occurs within 12-24 hours post-delivery, with increased output for 2-5 days.
    • A full bladder can displace the uterus and cause hemorrhage; adequate bladder emptying is crucial.

    Vital Signs Monitoring

    • Normal postpartum temperature is afebrile; an elevation could indicate dehydration.
    • Significant blood pressure changes may signal bleeding or postpartum hypertension.
    • Orthostatic hypotension is common in the first 48 hours.

    Cardiovascular Changes

    • Blood volume decreases as the body auromatically adapts postpartum.
    • Expected average blood loss is 500 ml for vaginal births and 500-1000 ml for cesarean.
    • Signs of deep vein thrombosis (DVT) may be indicated by Homans sign, although it is not a definitive measure.

    Breastfeeding

    • Initiating breastfeeding within the first hour post-birth is optimal for bonding and nutrition.
    • Breastfeed on demand; newborns typically nurse every 2-3 hours.
    • Monitor feeding effectiveness by the wet diaper count and stool output.

    Psychological Adaptations

    • The postpartum period requires adjustment and adaptation for the mother and family.
    • Mothers may experience a range of emotional responses, including anxiety about caring for the newborn.
    • Initial days post-birth focus on mother's self-care, but by days 2-3, mothers often seek to regain control.

    Nutritional Needs Postpartum

    • Nutritional intake should increase for breastfeeding mothers; inadequate calories may reduce milk volume.
    • Encourage balanced meals rich in calories and continue iron supplements for 2-3 months post-delivery.

    Cultural Considerations

    • Be mindful of cultural practices related to postpartum care, such as rest and dietary constraints.
    • Engage family members in teaching sessions, especially in cultures where extended family support is common.

    Sudden Infant Death Syndrome (SIDS)

    • SIDS is a leading cause of death in infants aged 1 to 12 months, often with no prior warning signs.
    • SIDS is associated with brain defects governing breathing and sleep arousal; confirmed only after autopsy.
    • Risk factors include preterm birth, male gender, inappropriate sleeping positions, loose bedding, and tobacco smoke exposure.

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    Description

    This quiz covers the signs and symptoms of hypertensive disease in pregnancy, including changes in temperature, perfusion, urine output, and blood pressure. It also explores the use of pulse oximetry and physical examinations to assess oxygen delivery and tissue perfusion.

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