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Exam (elaborations)

NURS U340 STUDY QUESTIONS AND ANSWERS

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Cardiovascular and Respiratory Assessment Abdominal, Musculoskeletal, and Neurological Assessment Pediatric and Geriatric Assessments Use of Diagnostic Tools (e.g., stethoscopes, otoscopes) Understanding Abnormal Findings and Next Steps

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  • August 31, 2024
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  • 2024/2025
  • Exam (elaborations)
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  • nurs u340
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NURS U340 STUDY GUIDE QUESTIONS AND ANSWERS

Most common medical complication reported during pregnancy: - HTN


Gestational HTN - onset of HTN after 20 weeks with no proteinuria


Pre-eclampisa - onset of HTN after 20 weeks + proteinuria


OR


onset of HTN after 20 weeks + ANY of these: thrombocytopenia, renal
insufficiency, impaired liver function, pulmonary edema, vision issues


**ONSET OF HTN: SBP greater than or equal to 140 or greater than or equal to
90 GREATER THAN 20 WEEKS


BEST definition for preeclampsia - idiopathic multisystem syndrome of pregnancy
involving reduced organ perfusion due to vasospasm


MOST telling maternal symptom of preeclampsia: - "just don't feel right"


others include: generalized edema, weight gain >5 lbs in 1 week, epigastric pain,
HA unrelieved by Tylenol, visual changes


Diagnostic criteria of severe preeclampsia includes any of these: - SBP > or = 160 /
DBP > or = 110
oliguria

,epigastric, RUQ pain
thrombocytopenia
impaired liver/renal function
pulmonary edema
cerebral/visual issues


Eclampsia - onset of seizure activity due to cerebral vasospasm r/t pre-e


WARNING signs of eclampsia: - HA, severe epigastric pain, n/v, hyperreflexia,
scotoma, blurred vision, hemoconcentration, NO WARNING


Can seizures occur PP? - YES up to 48-72 hours PP


Tx of seizure - AIRWAY, O2, FHR (late decels), FLUIDS (100-125 mL/hr)


Cure for preeclampsia - delivery of baby and placenta


Pre-e or GHTN at 37 weeks: - delivery


Pre-e or GHTN w/ severe features at 34 weeks: - delivery


Should diuretics be used to tx pre-e or GHTN? - NO! -- will decrease perfusion to
baby due to decreasing the BV


Proteinuria diagnostic criteria: - 24 hour urine specimen: 300mg / day
Ratio: 0.3

, Dipstick: +1 protein


MgSO4 function - CNS depressant, smooth muscle relaxant
1/2 risk of eclampsia and reduces risk of maternal death
ALSO--neuroprotection of baby


Pitocin and MgSO4 - work against each other--pitocin should not used if recently
given MgSO4 and if used we will need A LOT of it


MgSO4 and Kidneys - NEED ADEQUATE KIDNEY FUNCTION (30mL/hr)
otherwise TOXICITY can ensue


MgSO4 therapeutic serum level - 4-7


Normal symptoms of MgSO4 - nausea, feeling of warmth, flushing


Signs of MgSO4 toxicity - muscle weakness, hyporeflexia, slurred speech,
respiratory depression, oliguria, decreased LOC


MgSO4 antidote: - calcium gluconate


Nursing considerations with MgSO4: - double check
1) at shift change
2) dose change
3) started

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