hypertension RELIAS
A 19-year-old woman, who was delivered 1 week ago by normal vaginal delivery, returns to
the hospital today with a severe headache. Her blood pressure is 130/84 mm Hg in the
Semi-Fowler's position. Her husband reports that she has been sleeping poorly-caring for
the baby. Her serum creatinine is 1.2 mg/dL. A diagnosis of preeclampsia with severe
features would be supported by which of the following? - ANS-Select 2 answers.
The patient has a history of seizures.
*Her liver enzymes are more than twice normal.
*She has a grand mal seizure at this time.??
She experienced a preterm birth with this delivery.
\A 24-year-old G2P1 presents for her first prenatal visit at 14 weeks. She states that she has
a history of systemic lupus erythematosus, but it is not active presently. Her BP is 180/120
mm Hg. What are the correct next steps?
Select all that apply.
Check cuff size and repeat BP within 15 minutes as you tell the prenatal care provider.
Ask if she has white coat syndrome.
Check the BP on the other arm.
Immediately ask for an order for an antihypertensive. - ANS-white coat syndrome?
check cuff?
swap arms? noi idea wtf
\A 25-year-old nulliparous patient at 30 weeks' gestation arrives to the emergency room with
a sore throat. She is found to have a blood pressure of 150/90 mm Hg. She is sent to labor
and delivery for further evaluation of the hypertension. The blood pressure is repeated while
she is in the Semi-Fowler's position and noted to be 128/70 mm Hg.
If the assessment is...
The patient may have preeclampsia.
And then you find...
She has been taking over-the-counter medications for nasal congestion. - ANS-poss
invalidated
\A 27-year-old G1P0 with a twin gestation at 32 weeks presents to labor and delivery for a
preeclampsia evaluation after elevated blood pressures were noted at her scheduled
prenatal visit. The patient's blood pressures on labor and delivery range from 130-142/90-94
mm Hg. Urine protein/creatinine ratio is 0.2 mg/dL, and all preeclamptic labs are within
normal limits. Fetal testing is reassuring. The provider diagnoses gestational hypertension.
If the plan is to...
Discharge the patient home; follow-up with weekly blood pressure checks, labs, and fetal
testing.
And then you find...
The patient develops a headache unrelieved with acetaminophen.
Then the initial plan becomes... - ANS-possibly invalidated
\A 28-year-old G2P0 with a history of well-controlled chronic hypertension on labetalol 200
mg BID has an elevated BP of 155/95 mm Hg noted at the time of her 34-week scheduled
prenatal visit. A urine dipstick performed is negative for protein.
Appropriate management at this time would include which of the following?
, Select 3 answers.
Assess for signs/symptoms of preeclampsia
Increase her dose of labetalol
Check preeclamptic labs (CBC, liver enzymes, creatinine)
Discharge with 1-week follow-up plan for blood pressure check
Perform fetal nonstress testing - ANS-Assess for signs/symptoms of preeclampsia
Check preeclamptic labs (CBC, liver enzymes, creatinine)
Perform fetal nonstress testing
\A 28-year-old G2P1 is considering becoming pregnant. She tells you that her prior
pregnancy was complicated by preeclampsia diagnosed at 17 weeks. Her blood pressure
today is 146/92 mm Hg. What is the likely diagnosis for her last pregnancy?
Select an answer.
Systemic lupus erythematosus
Chronic hypertension
Gestational hypertension
Preeclampsia - ANS-chronic
\A 29-year-old G2P1 presents for her first prenatal visit at 22 weeks' gestation. Her blood
pressure is 144/90 mm Hg, and her urine dipstick is negative for protein. She denies any
signs or symptoms of preeclampsia, and lab work is pending. Fetal ultrasound shows the
fetal heart rate is in the 150s with the estimated fetal weight in the 40th percentile. Which of
the following categories of hypertensive disorders of pregnancy can be excluded?
Select an answer.
Preeclampsia
Chronic (preexisting) hypertension
Gestational hypertension
Chronic hypertension with superimposed preeclampsia
None of the diagnoses can be excluded - ANS-none?
\A 29-year-old G2P1 with a history of chronic hypertension is being seen for her first prenatal
visit at 20 weeks' gestation. Her BP is 128/78 mm Hg without medications. She is very happy
to have such a low BP. Why is it so low?
Select all that apply.
It is normal for the BP to decrease in the second trimester, regardless of hypertensive status.
You may have used a cuff that was too large.
She had previously started aspirin, and it is keeping her BP decreased.
Your office environment has a very relaxing effect on patients. - ANS-You may have used a
cuff that was too large.
She had previously started aspirin, and it is keeping her BP decreased.
\A 30-year-old G1P0 at 32 weeks' gestation presents for a routine prenatal visit. She has no
prior risk factors for hypertensive disease in pregnancy. Her blood pressure is 136/84 mm
Hg. She has no neurologic symptoms or other complaints. Which of the following are
accepted diagnostic tests for preeclampsia?
Select all that apply.
Magnesium
Creatinine
Uric acid
Platelet count
A 19-year-old woman, who was delivered 1 week ago by normal vaginal delivery, returns to
the hospital today with a severe headache. Her blood pressure is 130/84 mm Hg in the
Semi-Fowler's position. Her husband reports that she has been sleeping poorly-caring for
the baby. Her serum creatinine is 1.2 mg/dL. A diagnosis of preeclampsia with severe
features would be supported by which of the following? - ANS-Select 2 answers.
The patient has a history of seizures.
*Her liver enzymes are more than twice normal.
*She has a grand mal seizure at this time.??
She experienced a preterm birth with this delivery.
\A 24-year-old G2P1 presents for her first prenatal visit at 14 weeks. She states that she has
a history of systemic lupus erythematosus, but it is not active presently. Her BP is 180/120
mm Hg. What are the correct next steps?
Select all that apply.
Check cuff size and repeat BP within 15 minutes as you tell the prenatal care provider.
Ask if she has white coat syndrome.
Check the BP on the other arm.
Immediately ask for an order for an antihypertensive. - ANS-white coat syndrome?
check cuff?
swap arms? noi idea wtf
\A 25-year-old nulliparous patient at 30 weeks' gestation arrives to the emergency room with
a sore throat. She is found to have a blood pressure of 150/90 mm Hg. She is sent to labor
and delivery for further evaluation of the hypertension. The blood pressure is repeated while
she is in the Semi-Fowler's position and noted to be 128/70 mm Hg.
If the assessment is...
The patient may have preeclampsia.
And then you find...
She has been taking over-the-counter medications for nasal congestion. - ANS-poss
invalidated
\A 27-year-old G1P0 with a twin gestation at 32 weeks presents to labor and delivery for a
preeclampsia evaluation after elevated blood pressures were noted at her scheduled
prenatal visit. The patient's blood pressures on labor and delivery range from 130-142/90-94
mm Hg. Urine protein/creatinine ratio is 0.2 mg/dL, and all preeclamptic labs are within
normal limits. Fetal testing is reassuring. The provider diagnoses gestational hypertension.
If the plan is to...
Discharge the patient home; follow-up with weekly blood pressure checks, labs, and fetal
testing.
And then you find...
The patient develops a headache unrelieved with acetaminophen.
Then the initial plan becomes... - ANS-possibly invalidated
\A 28-year-old G2P0 with a history of well-controlled chronic hypertension on labetalol 200
mg BID has an elevated BP of 155/95 mm Hg noted at the time of her 34-week scheduled
prenatal visit. A urine dipstick performed is negative for protein.
Appropriate management at this time would include which of the following?
, Select 3 answers.
Assess for signs/symptoms of preeclampsia
Increase her dose of labetalol
Check preeclamptic labs (CBC, liver enzymes, creatinine)
Discharge with 1-week follow-up plan for blood pressure check
Perform fetal nonstress testing - ANS-Assess for signs/symptoms of preeclampsia
Check preeclamptic labs (CBC, liver enzymes, creatinine)
Perform fetal nonstress testing
\A 28-year-old G2P1 is considering becoming pregnant. She tells you that her prior
pregnancy was complicated by preeclampsia diagnosed at 17 weeks. Her blood pressure
today is 146/92 mm Hg. What is the likely diagnosis for her last pregnancy?
Select an answer.
Systemic lupus erythematosus
Chronic hypertension
Gestational hypertension
Preeclampsia - ANS-chronic
\A 29-year-old G2P1 presents for her first prenatal visit at 22 weeks' gestation. Her blood
pressure is 144/90 mm Hg, and her urine dipstick is negative for protein. She denies any
signs or symptoms of preeclampsia, and lab work is pending. Fetal ultrasound shows the
fetal heart rate is in the 150s with the estimated fetal weight in the 40th percentile. Which of
the following categories of hypertensive disorders of pregnancy can be excluded?
Select an answer.
Preeclampsia
Chronic (preexisting) hypertension
Gestational hypertension
Chronic hypertension with superimposed preeclampsia
None of the diagnoses can be excluded - ANS-none?
\A 29-year-old G2P1 with a history of chronic hypertension is being seen for her first prenatal
visit at 20 weeks' gestation. Her BP is 128/78 mm Hg without medications. She is very happy
to have such a low BP. Why is it so low?
Select all that apply.
It is normal for the BP to decrease in the second trimester, regardless of hypertensive status.
You may have used a cuff that was too large.
She had previously started aspirin, and it is keeping her BP decreased.
Your office environment has a very relaxing effect on patients. - ANS-You may have used a
cuff that was too large.
She had previously started aspirin, and it is keeping her BP decreased.
\A 30-year-old G1P0 at 32 weeks' gestation presents for a routine prenatal visit. She has no
prior risk factors for hypertensive disease in pregnancy. Her blood pressure is 136/84 mm
Hg. She has no neurologic symptoms or other complaints. Which of the following are
accepted diagnostic tests for preeclampsia?
Select all that apply.
Magnesium
Creatinine
Uric acid
Platelet count
