Gestational Hypertension & Antihypertensive Medications
Gestational hypertension begins after which week of pregnancy?
The 20th week
Blood pressures must be equal or greater than what to be classified as severe preeclampsia?
160/100 mm Hg
What condition does HELLP syndrome often occur with?
Severe preeclampsia
What is the antidote for magnesium toxicity?
Calcium gluconate or calcium chloride
During the postpartum period blood pressure returns to baseline by?
12 weeks postpartum
What lab values are elevated in severe preeclampsia?
Proteinuria greater than 3+ & blood creatinine greater than 1.1 mg/dL
What does the different aspects of HELLP stand for?
H: Hemolysis EL: Elevated liver enzymes LP: Low platelets
How does magnesium sulfate prevent seizure activity in patients with preeclampsia?
Depresses the CNS
How is gestational hypertension diagnosed?
A blood pressure at 140/90 mm Hg or greater taken on two different occasions, at least 4 hr apart
What are common assessment findings in severe preeclampsia?
What liver enzymes are elevated in HELLP syndrome?
AST, ALT, & lactic dehydrogenase (LDH)
Absent reflexes, respiratory rate less than 12, urinary output less than 30 mL/hr, altered consciousness, & cardiac dysrhythmias
What antihypertensive medications are safe to administer to pregnant women?
Methyldopa, nifedipine, hydralazine, labetalol
What are risk factors for developing severe preeclampsia?
What are some nursing interventions/considerations for patients with HELLP syndrome?
Seizure precautions, fall precautions, low stim environments
Patients with a magnesium sulfate bolus may experience what kind of symptoms?
Heat, flushing, diaphoresis, sedation, and burning at the IV site
What antihypertensive medications are contraindicated for use in pregnancy?
ACE inhibitors and angiotensin II receptor blockers
What are you looking for when you check clonus and why do we check for clonus?
Beats of clonus following dorsiflexion of the ankle and it reflects neuromuscular irritability
What are some complications that can result from platelets less than 100,000?
Thrombocytopenia, increased risk of bleeding, prolonged clotting time, & DIC
What is considered a therapeutic magnesium level for treating severe preeclampsia?
3.5-7 mg/dL