click below
click below
Normal Size Small Size show me how
PIH
Pregnancy induced hypertension
Question | Answer |
---|---|
What two things have to be present for diagnosis of PIH? | High B/P, and Protein in urine |
What are Risk factors for PIH? | First pregnancy Age less than 20 and greater than 35 family hx obesity diabetes Multi fetal pregnancy- twins angiotensin Gene T235 Chronic hypertension or renal disease |
What are the classic symptoms of PIH? | High B/P >140/90 Protein in urine Edema above the waist (hands, face) |
PIH Symptoms that effect Nervous system | headache seizures drowsiness Brisk reflexes |
PIH Symptoms that effect Ophthalmologic | Visual disturbance- blurring, double vision, see spots |
PIH Symptoms that effect Dermatologic | Edema |
PIH Symptoms that effect Cardiopulmonary | Heart attack stroke |
PIH Symptoms that effect Renal | kidney disease decreased urinary output increased protein |
PIH symptoms that effect gastrointestinal | N/V upper right abdominal pain |
PIH symptoms that effect Musculoskeletal | pain |
Patho for PIH | Result of Vasospasm leaky vessels- from damage to cell lining in arterioles leaky vessels then cause the body to think it has lost fluid Kidneys then hold fluid - decreasing output which makes blood viscous and start spilling protein |
Liver during PIH | decrease flow during vasospasm causing damage or necrosis- not enough nutrients to baby |
Brain during PIH | has decreased flow causing hemorrhage in small capillaries |
Placenta during PIH | Has decreased flow during vasospasm...IUGR, abruption, hypoxia- cant get O2 to baby, can be emergency situation for baby |
What lab work is used for diagnosis of PIH | urine test- see if protein present CBC- looking for platelet chem with liver profile uric acid-see if kidneys working properly type& screen - to see if we need to replace blood |
How can you tell if PIH is worsening? | If symptoms become severe B/P 160/110 ect... |
What is the top priority of Mom and baby with PIH? | safety |
What is the goal and cure of PIH? | delivery of baby |
How do you prevent PIH? | Good prenatal care Medications and supplements have not been proven to prevent it NO CURE YET |
What are the top Nursing interventions for PIH | Hourly checks: Assess B/P , temp, pulse, RR (anything below 12) Monitor urine out put (want above 30) monitor weight gain Assess: reflexes (absent resp.arrest) for edema monitor consciousness Give mom Mag sulfate Give baby Steroids |
When do you give steroids for baby? | Anything before 34 wks gets steroids Anything after does not |
Is vaginal delivery or c-section preferred? | vaginal delivery C-section only for emergency situations |
What is good and normal for urinary output? | anything above 30cc/ hr |
What medications are for PIH? | magnesium sulfate Hydralazine Labetalol Nifedipine |
Magnesium sulfate | Used to prevent seizure NOT b/p med High alert- need 2 nurses to start |
Hydralazine | vasodilator |
Labetalol | beta blocker |
Nifedipine | calcium channel blocker |
Mild PIH | exhibit few if any symptoms b/p is 140/90 or higher 1+ proteinuria may occur liver enzymes may be elevated minimally edema may be present |
Severe PIH | Develop suddenly B/P 160/110 or higher on 2 occasions Proteinuria 5g or higher in 24 hr collection 3+ to 4+ on 2 random samples @ least 4hrs apart Oliguria is present Urine output equal or less to 500ml in 24 hrs |
Other symptoms of severe PIH | N/V irritability hyperreflexia retinal edema |
HELLP | Hemolysis- broken down RBC Elevated liver enzymes- very elevated Low platelets- very low, can have sig. bleed Serious complication |
HELLP prominent symptoms | upper right quad pain severe edema N/V mortality is high |
HELLP sometimes complicated by? | DIC ( Disseminating Intravascular Coagulopathy)- Body not able to coagulate blood w/ potential to hemorrhage -from anywhere , any opening |
PIH is also known as | Toxemia Preeclampsia |