Gestational Hypertension > Maternal & Newborn
Exam Review
Diagnosis and tests
Total Questions : 5
Showing 5 questions, Sign in for moreA nurse is assessing a pregnant woman with gestational hypertension.
Which of the following blood pressure readings would lead the nurse to suspect that the client has gestational hypertension?
Explanation
The correct answer is choice B.Choice B is correct because gestational hypertension is defined as a blood pressure (BP) of≥140/90 mmHgon two occasions (at least 4 hours apart) after 20 weeks’ gestation in a previously normotensive woman, without the presence of proteinuria or other clinical features suggestive of preeclampsia.
Choice A is wrong because 130/80 mmHg is within the normal range for blood pressure in pregnancy.
Choice C is wrong because 120/70 mmHg is also within the normal range for blood pressure in pregnancy.
Choice D is wrong because 110/60 mmHg is on the lower end of the normal range for blood pressure in pregnancy and does not indicate hypertension.
Normal blood pressure in pregnancy is usually between 110/70 and 120/80 mmHg.Blood pressure can vary throughout the day and may change with activity, stress, or position
A client is diagnosed with gestational hypertension.
Which of the following tests should the nurse expect to be ordered?
Explanation
The correct answer is choiceC.
An ultrasound to measure fetal growth and amniotic fluid volume is a test that the nurse should expect to be ordered for a client with gestational hypertension.This is because gestational hypertension can cause intrauterine growth restriction and oligohydramnios, which are conditions that affect the fetal development and well-being.
ChoiceAis wrong because urinalysis to check for proteinuria is not a specific test for gestational hypertension, but rather for preeclampsia, which is a more severe complication of gestational hypertension.Proteinuria indicates impaired kidney function due to high blood pressure.
ChoiceBis wrong because blood tests to check for liver enzymes are also not specific for gestational hypertension, but for HELLP syndrome, which is another severe complication of preeclampsia.Elevated liver enzymes indicate impaired liver function due to high blood pressure.
ChoiceDis wrong because nonstress test or biophysical profile to monitor fetal heart rate and movements are not tests that are ordered for gestational hypertension alone, but for any high-risk pregnancy that requires close monitoring of the fetal status.These tests can detect signs of fetal distress or hypoxia.
A nurse is caring for a client with gestational hypertension.
Which of the following symptoms would indicate that the client is developing preeclampsia?
Explanation
The correct answer is choice B.Proteinuria greater than 300 mg in a 24-hour urine collection is one of the criteria for diagnosing preeclampsia, along with hypertension and edema.
Proteinuria indicates that the kidneys are not functioning properly due to the increased blood pressure.
Choice A is wrong because blood pressure of 140/90 mmHg or higher is a sign of gestational hypertension, not preeclampsia.Gestational hypertension is a risk factor for developing preeclampsia, but it does not necessarily mean that the client has preeclampsia.
Choice C is wrong because mild facial edema is a common finding in normal pregnancy and does not indicate preeclampsia.Edema in preeclampsia is usually generalized and severe.
Choice D is wrong because hyperreflexia is a sign of eclampsia, not preeclampsia.Eclampsia is a complication of preeclampsia that involves seizures and coma.
Hyperreflexia indicates increased nervous system irritability due to the high blood pressure.
Normal ranges for blood pressure and proteinuria in pregnancy are:
• Blood pressure: less than 140/90 mmHg
• Proteinuria: less than 300 mg/24 hours
A nurse is caring for a client with gestational hypertension who is at risk for preterm labor.
Which of the following medications should the nurse expect to be ordered?
Explanation
The correct answer is choice C. Nifedipine.Nifedipine is a calcium channel blocker that can be used to treat gestational hypertension and prevent preterm labor by relaxing the smooth muscles of the uterus and blood vessels.It also lowers blood pressure and reduces the risk of preeclampsia.
Choice A is wrong because magnesium sulfate is used to prevent seizures in severe preeclampsia or eclampsia, not to prevent preterm labor.It can also cause adverse effects such as respiratory depression, hypotension, and decreased reflexes.
Choice B is wrong because oxytocin is used to induce or augment labor, not to prevent it.It can also cause adverse effects such as uterine hyperstimulation, fetal distress, and water intoxication.
Choice D is wrong because misoprostol is used to ripen the cervix and induce labor, not to prevent it.It can also cause adverse effects such as uterine rupture, diarrhea, and fever.
A nurse is teaching a client with gestational hypertension about self-care measures to manage her condition at home.
Which of the following instructions should the nurse include?
Explanation
This is because gestational hypertension can cause complications for both the mother and the baby, such as preeclampsia, placental abruption, and intrauterine growth restriction.
Monitoring blood pressure at home can help detect any changes or signs of worsening condition and prompt early intervention.
Choice A is wrong because limiting fluid intake to less than 1 liter per day can cause dehydration and increase blood viscosity, which can worsen hypertension and increase the risk of thrombosis.
Fluid intake should be adequate and balanced to maintain hydration and electrolyte balance.
Choice B is wrong because lying on the left side can help reduce pressure on the inferior vena cava and improve blood flow to the uterus and the kidneys.
Lying on the right side or supine can impair venous return and increase blood pressure.
Choice D is wrong because acetaminophen is a safe and effective analgesic and antipyretic for pregnant women.
It does not affect blood pressure or cause harm to the fetus.
Other medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin, should be avoided as they can increase the risk of bleeding, renal impairment, or premature closure of the ductus arteriosus.
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