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Maternity and Women's Health Care, 12th Ed., Lowerdermilk, Perry, Cashion & Aldon, 2020
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27 - Hypertensive Disorders

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Maternity and Women's Health Care, 12th Ed., Lowerdermilk, Perry, Cashion & Aldon, 2020 | Registered Nurse (RN) School Study Aid

27 - Hypertensive Disorders
17 Picmonics to Learn | 28 mins
Lab and Diagnostic Tests During Pregnancy
Complete Blood Cell Count
Blood Typing
Rubella Titer
Hepatitis B
HIV Testing
Urinalysis
Diabetes
Pap Smears
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2 mins
Hemoglobin (Hgb) Lab Values
Men: 13 - 17 g/dL
Women: 12 - 16 g/dL
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47 secs
Platelet Lab Value
150,000-400,000 Micro L
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40 secs
Creatinine Lab Values
Measures Renal Function
0.6 - 1.3 mg/dL
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1 min
Hypertension Assessment
Mechanism
Essential Hypertension
Secondary Hypertension
Assessment
Headache
Vision Changes
Nosebleed (Epistaxis)
Chest Pain
Syncope (Fainting)
Diagnosis
Average 2 Sets, 2 Minutes Apart
After 2 or More Visits (within 1-4 weeks)
Nursing Considerations
Take BP Both Arms
Common in African Americans
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2 mins
Preeclampsia Assessment
After 20 Weeks of Pregnancy
Mild
Hypertension > 140/90
Proteinuria or End-Organ Dysfunction
Severe
Hypertension > 160/110
Progressive Renal Insufficiency
Vision Changes
HELLP Syndrome
Pulmonary Edema
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2 mins
Eclampsia
Mechanism of Action
Increased Central Nervous System Irritability
Signs and Symptoms
Hyperreflexia
Positive Ankle Clonus
Headaches
Visual Disturbances
Epigastric or RUQ Pain
Seizures
Coma
Considerations
Don't Leave Bedside
Magnesium Sulfate
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2 mins
Liver Enzyme Tests: AST and ALT
AST/ALT Ratio
AST: 8-20 U/L
ALT: 8-20 U/L
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1 min
PT/PTT Lab Values
Prothrombin Time (PT)
10-14 seconds
Activated Partial Thromboplastin Time (PTT or aPTT)
25-35 seconds
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1 min
Hypertension Intervention
Lifestyle Modifications
Weight Reduction and Exercise
Diet Changes
Relaxation Techniques
Smoking Cessation
Medications
Encourage Self Monitoring
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1 min
Preeclampsia Interventions
Side Lying Position and Bedrest
Antihypertensives
Magnesium Sulfate
Labor Induction
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1 min
Severe Preeclampsia
Mechanism of Action
Vasospasm and Decreased Organ Perfusion
Intravascular Coagulation
Increased Permeability and Capillary Leakage
Signs and Symptoms
Hypertension
Proteinuria or End-Organ Dysfunction
HELLP Syndrome
Hepatic Dysfunction and Hemolysis
Elevated Liver Enzymes
Low Platelet Counts
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3 mins
Magnesium Sulfate
Mechanism
Muscle Relaxant
Indications
Preterm Labor Contractions
Preeclampsia
Side Effects
Warm Feeling
Hypotension
Decreased Deep Tendon Reflexes (DTRS)
Decreased Respiratory Rate
Decreased Urine Output
Paralytic Ileus
Antidote
Calcium Gluconate
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2 mins
Hydralazine (Apresoline)
Indications
Severe Hypertension
CHF
Reduced Afterload
Pregnancy
Mechanism of Action
Vasodilates Arterioles
Side Effects
Drug-induced Lupus
Reflex Tachycardia
Hypotension
Considerations
Combined with Diuretic and Beta Blocker
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1 min
Hypertension Medications
Diuretics
ACE Inhibitors
Angiotensin Receptor Blockers (ARBs)
Beta Blockers
Dihydropyridine Calcium Channel Blockers
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2 mins
Calcium Channel Blockers (Verapamil and Diltiazem)
Mechanism of Action
Slows AV Conduction
Indications
Angina Pectoris
Arrhythmias
Essential Hypertension
Side Effects
Bradycardia
Hypotension
Constipation
Peripheral Edema
Gingival Hyperplasia
Nursing Consideration
Medication Education
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2 mins
Beta Blockers
"-olol" suffix
Mechanism
Decreases Heart Rate and Contractility
Decreases Peripheral Vascular Resistance
Decreases Renin Release
Indications
Hypertension
Heart Failure
Angina Pectoris
Contraindications
Asthma and Heart Block Patients
Nursing Considerations
Assess Blood Pressure and Heart Rate
Masking Signs of Hypoglycemia
Do Not Stop Abruptly
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2 mins

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