Hypertension in Pregnancy

Which of the following is the best description of the presentation of pre-eclampsia?
1. Hypertension with seizure activity after 28 weeks
2. Preexisting hypertension before pregnancy, with proteinuria developing before 20 weeks
3. Hypertension with pedal edema, which develops after 20 weeks
4. Hypertension with proteinuria, which develops after 20 weeks
What is the best description of the pathophysiology of pre-eclampsia?
1. Localized condition impacting uteroplacental perfusion
2. Localized condition impacting maternal hepatic function
3. Multisystem disorder resulting in generalized vasodilation
4. Multisystem disorder resulting in generalized vasoconstriction
Which of the following findings in the patient’s prenatal record would indicate a risk for pre-eclampsia? (select all that apply)
1. African American ethnicity
2. First pregnancy
3. Asian Ethnicity
4. BMI less than 20
5. Low Socio-economic status
In what position is a blood pressure the lowest?
Standing
Supine
Side- lying
Sitiing
Which finding upon assessment would be most concerning for a patient at risk for pre-eclampsia?
White sparkly vision changes
Headache relieved by Tylenol, rest and hydration
Constant pain under the right breast
Dependent edema in ankles
What is the physiologic change associated with headache with a pre-eclamptic patient?
Circulating Toxins
Vasoconstriction
Vasodilation
Generalize hypoxia
What fetal testing should be completed twice a week until the baby is born?
Fetal Kick Counts
Non-Stress Tests
BBP (Biophysical Profile)
L/S Ration
Which of the following are signs and symptoms of worsening pre-eclampsia? Select all that apply
Headache
Blurred Vision
Dependent Edema
Rupture of Membranes
Epigastric pain
What does the "H" stand for in HELLP
Hypertension
Hemolysis
Hepatitis
Hypotension
Which of the following assessment findings are consistent with pre-eclampsia? Select all that apply
Protein/Creatinine ratio 0.45
Epigastric pain
Fatigue
Blood pressure 142/92
Ankle swelling
Which assessments would be consistent nervous system irritability? Select all that apply
Blood pressure
Clonus Present
Reflexes 3+
AST/ALT lab values
Black spots in vision
How does pre-eclampsia affect the fetus?
1. Growth restriction due to decreased blood flow to the uterus and placenta
2. It does not affect the fetus
3. Blood flow to the placenta is increased causing macrosomia
4. Decreased blood flow to the placenta causes onset of labor
What is considered a severe range blood pressure?
138/90
162/100
159/95
124/94
149/101
Triaging a patient with hypertension, what labs would you obtain?
CBC
CMP
Urine Analysis
P/C ratio
INR
What is your priority if you patient is having a seizure?
Call a C-Section
Maintain safety and airway
Intrauterine resusciation
Increase contractions with oxytocin
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