Midwifery I – Final Exam – Study Guide & Practice Questions
How is chronic hypertension diagnosed? - correct answer ✔✔HTN prior to conception or prior
to 20 weeks
Mild chronic HTN
Severe chronic HTN - correct answer ✔✔>140/90
>160/110
Persists for at least 12 weeks postpartum
Baseline labs for chronic HTN
Medications? - correct answer ✔✔CBC, LFTS, creatinine, protein/creatinine ratio
Antihypertensives not recommended unless they were on something before, labetolol is
commonly used
Management of chronic HTN--when to see pt and tests to perform?
Patient education? What should they watch out for? - correct answer ✔✔Visits every 3 weeks
NST, BPP, growth US
Manage diet, salt intake, exercise
Visual changes, decreased fetal movement, manage BP at home and report >140/90, new-onset
headache that won't go away with tylenol, heart burn that won't go away with tums, edema
above elbows/knees or face
Complications of chronic HTN---what are they are at high risk for? - correct answer ✔✔High risk
for: preterm labor, placental abruption, cesarean, IUGR, oligohydramnios
,When is a pt considered to have gestational htn?
Can she have proteinuria?
Does it resolve postpartum? - correct answer ✔✔Has two separate readings >140 systolic OR 90
diastolic (for the first time) at least 6 hours apart AFTER 20 weeks gestation
No proteinuria
Resolves within 12 weeks postpartum
What labs to monitor for gestational HTN?
Management? what tests to run? - correct answer ✔✔urine protein, platelets, LFTs
Serial growth U/S, BP readings at home 2x
No medications are necessary
Watch for s/s of preeclampsia
1. Pathophysiology of preeclamspia
2. Mild preeclamspia defined as?
3. Severe preeclampsia defined as?
4. When does preeclampsia usually occur? - correct answer ✔✔1. Abnormal trophoblastic
invasion of the uterus at the placental site
Causes narrowing of spiral arteries
2. 2 separate readings at least 6 hrs apart >140 OR >90 after 20 weeks OR
Protein--> +300mg in 24 hr urine OR PCR 0.3 OR +1 urine dip on two samples at least 6 hrs apart
3. 2 separate readings at least 6 hrs apart >160 OR >110 after 20 weeks
Protein-->+500mg in 24 hr urine OR +3 urine dip on two samples 6hrs apart
, 4. Usually occurs late onset, >36 weeks
Diagnostic evaluation for preeclampsia
Severe features defined as? - correct answer ✔✔HTN after 20 weeks greater than 140/90 AND
ONE of the following:
Proteinuria Greater than 300 in 24 hour urine
PCR >0.3
Greater than 1+ dipstick
Visual or cerebral symptoms
Platelets <100,000
Serum creatinine >1.1
Elevated liver enzymes
Pulmonary edema
Systolic BP >160 OR diastolic >110 (BP bumps up to the next level)
Everything else the same as above ^
S/S of preeclampsia
What labs would you draw?
Surveillance? What things should you monitor? - correct answer ✔✔Visual changes
epigastric pain/RUQ pain
Headache
Dependent and facial edema
SOB
How is chronic hypertension diagnosed? - correct answer ✔✔HTN prior to conception or prior
to 20 weeks
Mild chronic HTN
Severe chronic HTN - correct answer ✔✔>140/90
>160/110
Persists for at least 12 weeks postpartum
Baseline labs for chronic HTN
Medications? - correct answer ✔✔CBC, LFTS, creatinine, protein/creatinine ratio
Antihypertensives not recommended unless they were on something before, labetolol is
commonly used
Management of chronic HTN--when to see pt and tests to perform?
Patient education? What should they watch out for? - correct answer ✔✔Visits every 3 weeks
NST, BPP, growth US
Manage diet, salt intake, exercise
Visual changes, decreased fetal movement, manage BP at home and report >140/90, new-onset
headache that won't go away with tylenol, heart burn that won't go away with tums, edema
above elbows/knees or face
Complications of chronic HTN---what are they are at high risk for? - correct answer ✔✔High risk
for: preterm labor, placental abruption, cesarean, IUGR, oligohydramnios
,When is a pt considered to have gestational htn?
Can she have proteinuria?
Does it resolve postpartum? - correct answer ✔✔Has two separate readings >140 systolic OR 90
diastolic (for the first time) at least 6 hours apart AFTER 20 weeks gestation
No proteinuria
Resolves within 12 weeks postpartum
What labs to monitor for gestational HTN?
Management? what tests to run? - correct answer ✔✔urine protein, platelets, LFTs
Serial growth U/S, BP readings at home 2x
No medications are necessary
Watch for s/s of preeclampsia
1. Pathophysiology of preeclamspia
2. Mild preeclamspia defined as?
3. Severe preeclampsia defined as?
4. When does preeclampsia usually occur? - correct answer ✔✔1. Abnormal trophoblastic
invasion of the uterus at the placental site
Causes narrowing of spiral arteries
2. 2 separate readings at least 6 hrs apart >140 OR >90 after 20 weeks OR
Protein--> +300mg in 24 hr urine OR PCR 0.3 OR +1 urine dip on two samples at least 6 hrs apart
3. 2 separate readings at least 6 hrs apart >160 OR >110 after 20 weeks
Protein-->+500mg in 24 hr urine OR +3 urine dip on two samples 6hrs apart
, 4. Usually occurs late onset, >36 weeks
Diagnostic evaluation for preeclampsia
Severe features defined as? - correct answer ✔✔HTN after 20 weeks greater than 140/90 AND
ONE of the following:
Proteinuria Greater than 300 in 24 hour urine
PCR >0.3
Greater than 1+ dipstick
Visual or cerebral symptoms
Platelets <100,000
Serum creatinine >1.1
Elevated liver enzymes
Pulmonary edema
Systolic BP >160 OR diastolic >110 (BP bumps up to the next level)
Everything else the same as above ^
S/S of preeclampsia
What labs would you draw?
Surveillance? What things should you monitor? - correct answer ✔✔Visual changes
epigastric pain/RUQ pain
Headache
Dependent and facial edema
SOB
