Nursing Assessment
A systolic pressure of 160 or greater and/or a diastolic pressure of 110 or greater.
What is a severely elevated blood pressure? Especially when occurring suddenly and persisting over 15 minutes.
* SBP > or equal to 140 or DBP > or equal to 90
* Pre-pregnancy or < 20 weeks
Chronic hypertension
This combined alpha and beta-blocker is contraindicated in patients with bronchial asthma, heart block and severe bradycardia.
Labatalol
If the PCT gets a patient’s BP of 161/90, what is your next step to treat the patient.
Repeat BP in 15 minutes.
This medication should NEVER be crushed.
Nifedipine
The blood pressure cuff should encircle _______% of the bare upper arm.
80%
* SBP > or equal to 140 or DBP > or equal to 90
* > 20 weeks
* absence of proteinuria or systemic signs/symptoms
Gestational HTN
This medication is a vasodilator and results in vasodilation of vascular smooth muscle.
Hydralazine
Name the differences between preeclampsia with severe features and preeclampsia without severe features.
Preeclampsia WITHOUT severe features is new onset HTN > or equal to 140 systolic and or > or equal to 90 diastolic (2 readings at least 4 hours apart). Accompanied by proteinuria or other signs of mild organ involvement.
Preeclampsia WITH severe features is severe range BP’s & signs of significant end-organ dysfunction: thrombocytopenia, elevated liver enzymes, RUQ pain, renal insufficiency, pulmonary edema, new HA or vision disturbance.
Once a BP threshold is achieved, how often should BP monitoring happen?
Every 10 minutes for one hour.
Then q15min for one hour
Then q30min for one hour
Then q1h for 4 hours
Sitting, semi-reclining, legs uncrossed, and no talking.
These are the recommended positions for patients while taking a blood pressure.
* SBP > or equal to 140 or DBP > or equal to 90
* Proteinuria with or without signs or symptoms
* Presentation of signs/symptoms/lab abnormalities but no proteinuria.
Pre-eclampsia
This medication is a calcium channel blocker that acts to relax the smooth muscle of the heart and blood vessels. Max daily dose is 180 mg.
Nifedipine
How soon should a BP be reassessed after giving Hydralazine?
20 mins
When should the physician be called for a severe range BP?
Call to physician for orders immediately after the 2 severe range pressures have been achieved 15 minutes apart.
In addition to elevated BP’s, these are other signs and symptoms a nurse would assess for in a hypertensive/preeclamptic patient.
Oliguria <500 mL/24 hour, renal insufficiency, HA, visual disturbances, pulmonary edema, epigastric/ RUQ pain, elevated LFT’s
* SBP > or equal to 140 or DBP of > or equal to 90
* Proteinuria with or without signs or symptoms
* Presentation of signs/symptoms/lab abnormalities but no proteinuria
*Seizures
Eclampsia
This first line medication should be administered over 2 minutes and a BP should be repeated in 10 minutes.
Labetalol
If the administration of IV antihypertensives is required, can the patient go visit her infant in NICU?
No, bed rest is the recommended activity for 3 hours following med admin.
What is the meaning of a deep tendon reflex of 0?
No response=abnormal
The minimum urine output for a patient is_______
30 mL/hr
This disorder of pregnancy is characterized by vasospasm and endothelial damage, which may impact the cardiovascular, renal, hematological, neurologic, & hepatic system as well as the uteroplancental unit.
Preeclampsia
This is the first line drug used to prevent maternal eclamptic seizures.
Magnesium Sulfate
What can clonus be a clinical indicator of?
It can indicate severe preeclampsia and can be observed by repetitive, rhythmic contractions of a muscle.
Pulse oximetery should be used for how long following IVP labetalol?
At least 6 hours.