Gestational Hypertension > Maternal & Newborn
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Showing 21 questions, Sign in for moreWhich of the following factors increases a woman’s risk for developing gestational hypertension.
Explanation
The correct answer is choice D. All of the above.All of these factors increase a woman’s risk for developing gestational hypertension.
Choice A is wrong because nulliparity (having no previous pregnancies) is a risk factor for gestational hypertension.Rates in nulliparous women range from 6% to 17% while rates in multiparous women range from 2% to 4%.
Choice B is wrong because age younger than 20 years is a risk factor for gestational hypertension.Pregnant women more than 40 years or less than 18 years are at risk of gestational hypertension.
Choice C is wrong because history of chronic renal disease is a risk factor for gestational hypertension.High blood pressure can also cause problems during and after delivery, such as preeclampsia, eclampsia, stroke, and placental abruption.
Gestational hypertension is blood pressure greater than or equal to 140/90 that begins during the latter half of pregnancy (typically after 20 weeks) and goes away after childbirth.It can put the mother and her baby at risk for problems during the pregnancy, such as preterm delivery and low birth weight.
What is the most common cause of death in women with eclampsia.
Explanation
The correct answer is choice A. Cerebral hemorrhage.Eclampsia is a severe complication of preeclampsia that causes seizures and can lead to stroke or death.Cerebral hemorrhage is bleeding in the brain that can result from high blood pressure and swelling in the brain caused by eclampsia.It is one of the most common causes of death in women with eclampsia.
Choice B. Pulmonary edema is wrong because it is not the most common cause of death in women with eclampsia.
Pulmonary edema is fluid accumulation in the lungs that can impair breathing and oxygen exchange.It can occur as a complication of eclampsia, but it is less frequent than cerebral hemorrhage.
Choice C. Liver rupture is wrong because it is not the most common cause of death in women with eclampsia.
Liver rupture is a rare but serious complication of eclampsia that involves bleeding from the liver due to increased pressure and damage to the liver tissue.It can cause severe abdominal pain, shock and death.
Choice D. Disseminated intravascular coagulation (DIC) is wrong because it is not the most common cause of death in women with eclampsia.
DIC is a condition where the blood clotting system becomes overactive and forms clots throughout the body, leading to bleeding and organ failure.It can occur as a complication of eclampsia, but it is less common than cerebral hemorrhage.
Normal ranges for blood pressure are below 140/90 mmHg and for proteinuria are below 300 mg/24 hours or below 30 mg/dL in a urine sample.
What is a priority nursing intervention for a woman with severe preeclampsia who is receiving hydralazine IV.
Explanation
The correct answer is choice B. Monitor fetal heart rate continuously.This is because hydralazine is a vasodilator that lowers blood pressure and may cause tachycardia.Tachycardia can affect the fetal heart rate and oxygenation, so continuous monitoring is essential to detect any signs of fetal distress.
Choice A is wrong because hydralazine does not cause orthostatic hypotension, but rather a reflex increase in heart rate and cardiac output.
Orthostatic hypotension is more likely to occur with other antihypertensive drugs such as alpha-blockers or diuretics.
Choice C is wrong because encouraging oral fluid intake may worsen the fluid retention and edema that are common in preeclampsia.Fluid intake should be restricted to avoid pulmonary edema and cerebral edema.
Choice D is wrong because administering oxygen via nasal cannula is not a priority intervention for a woman with severe preeclampsia who is receiving hydralazine IV.Oxygen therapy may be indicated if the woman develops signs of hypoxia, such as dyspnea, cyanosis, or low oxygen saturation.However, oxygen therapy should be used with caution as it may increase oxidative stress and placental vasoconstriction.
A nurse is caring for a client with gestational hypertension who has been prescribed magnesium sulfate to prevent seizures related to preeclampsia.
Which of the following assessments should the nurse prioritize?
Explanation
The correct answer is choice D) Level of consciousness and reflexes.This is because magnesium sulfate can cause toxicity and affect the central nervous system, leading to decreased level of consciousness and loss of reflexes.These are signs that the dose of magnesium sulfate should be reduced or stopped.
The nurse should prioritize assessing these parameters to prevent seizures and avoid magnesium toxicity.
Choice A) Respiratory rate and depth is wrong because magnesium sulfate can also cause respiratory depression, but this is a less common and less sensitive indicator of toxicity than level of consciousness and reflexes.
Choice B) Urine output and color is wrong because magnesium sulfate can also cause renal impairment, but this is not directly related to preventing seizures.However, urine output should be monitored to ensure adequate hydration and renal function.
Choice C) Blood pressure and heart rate is wrong because magnesium sulfate can also cause hypotension and bradycardia, but these are not the primary goals of therapy.Blood pressure and heart rate should be monitored to assess the severity of preeclampsia and the response to antihypertensive medications.
A nurse is caring for a client with gestational hypertension who has been prescribed labetalol (Normodyne) to control blood pressure during pregnancy.
Which of the following statements by the client indicates an understanding of the medication?
Explanation
The correct answer is choice C) “I should report any dizziness or lightheadedness while taking this medication.” This is because labetalol can lower blood pressure and cause orthostatic hypotension, which can lead to falls and injuries.The patient should be advised to change positions slowly and monitor their blood pressure regularly while taking labetalol.
Choice A is wrong because labetalol can be taken with or without food.Taking it on an empty stomach does not affect its absorption or efficacy.
Choice B is wrong because labetalol does not affect potassium levels in the blood.Foods high in potassium are not contraindicated while taking this medication.
Choice D is wrong because swelling in the feet or hands can be a sign of worsening preeclampsia, which is a serious complication of hypertension in pregnancy.The patient should not stop taking labetalol without consulting their doctor, as this can cause rebound hypertension and endanger the mother and the fetus.The patient should seek medical attention if they experience swelling, headache, vision changes, abdominal pain, or reduced fetal movements.
A nurse is caring for a client with gestational hypertension who has been prescribed methyldopa (Aldomet) to control blood pressure during pregnancy.
Which of the following side effects should the nurse monitor for?
Explanation
Methyldopa is a drug that lowers blood pressure by reducing the activity of the sympathetic nervous system.
One of the possible side effects of methyldopa is hypotension, which means abnormally low blood pressure.Hypotension can cause dizziness, fainting, and shock.
Choice A) Bradycardia is wrong because methyldopa does not affect the heart rate directly.Bradycardia means a slow heart rate, which can be caused by other drugs or conditions.
Choice C) Hyperkalemia is wrong because methyldopa does not affect the potassium levels in the blood.Hyperkalemia means high potassium levels, which can be caused by kidney problems or other drugs.
Choice D) Hyperglycemia is wrong because methyldopa does not affect the glucose levels in the blood.Hyperglycemia means high glucose levels, which can be caused by diabetes or other conditions.
Normal ranges for blood pressure are 90/60 mmHg to 120/80 mmHg, for heart rate are 60 to 100 beats per minute, for potassium are 3.5 to 5.0 mmol/L, and for glucose are 70 to 100 mg/dL.
Which of the following is a sign or symptom of gestational hypertension?
Explanation
The correct answer is choice D) Swelling of the face, hands or feet.This is one of the signs and symptoms of gestational hypertension, which is high blood pressure that begins after 20 weeks of pregnancy and goes away after delivery.Gestational hypertension can lead to complications for both the mother and the baby, such as preeclampsia, which is a severe condition that causes protein in the urine and other problems.
Choice A) Severe headache is wrong because it is not a specific sign of gestational hypertension, but it can be a symptom of preeclampsia, which is a possible complication of gestational hypertension.
Choice B) Chest pain is wrong because it is not a common sign of gestational hypertension, but it can be a sign of a serious heart problem or a pulmonary embolism, which is a blood clot in the lungs.Chest pain during pregnancy should be evaluated by a doctor as soon as possible.
Choice C) Nausea or vomiting is wrong because it is not a typical sign of gestational hypertension, but it can be a symptom of preeclampsia or other conditions such as hyperemesis gravidarum, which is severe nausea and vomiting during pregnancy that can lead to dehydration and weight loss.
Normal blood pressure ranges for pregnant women are below 120/80 mm Hg.Gestational hypertension is diagnosed when the blood pressure is greater than or equal to 140/90 mm Hg after 20 weeks of pregnancy.
Which of the following signs and symptoms may indicate worsening condition or preeclampsia in a client with gestational hypertension?
Explanation
The correct answer ischoice A, B, D and E.These are all signs and symptoms that may indicate worsening condition or preeclampsia in a client with gestational hypertension.Preeclampsia is a complication of pregnancy that is marked by high blood pressure and presence of proteins in urine.
Choice C is wrong because chest pain or shortness of breath are not typical symptoms of preeclampsia, but they may indicate other serious conditions such as heart problems or pulmonary edema.
If a client with gestational hypertension experiences these symptoms, they should seek immediate medical attention.
Normal ranges for blood pressure and proteinuria are:
• Blood pressure: less than 140/90 mm Hg.
• Proteinuria: less than 300 mg in a 24-hour urine collection or less than 30 mg/dL in a random urine sample.
Which of the following signs and symptoms may indicate worsening condition or preeclampsia in a client with gestational hypertension?
Explanation
The correct answer is choice B, D and E. These are signs and symptoms of preeclampsia, a serious complication of gestational hypertension that can affect the mother and the baby.Preeclampsia is marked by high blood pressure and protein in urine or other signs of organ damage.
Choice A is wrong because swelling of the face, hands or feet is a common symptom of pregnancy and does not necessarily indicate preeclampsia.However, sudden or severe swelling can be a warning sign and should be checked by a healthcare provider.
Choice C is wrong because severe headache is a symptom of preeclampsia, not gestational hypertension.Gestational hypertension is high blood pressure that develops after 20 weeks of pregnancy and does not have protein in urine or other signs of organ damage.
Some normal ranges for blood pressure during pregnancy are:
• Systolic (top number): less than 140 mm Hg
• Diastolic (bottom number): less than 90 mm Hg
Some normal ranges for protein in urine during pregnancy are:
• Less than 300 mg per 24 hours
• Less than 0.3 g per liter
A client is diagnosed with preeclampsia and is receiving magnesium sulfate IV for seizure prophylaxis.
The nurse should monitor which of the following laboratory values?
Explanation
The correct answer is choice A) Serum magnesium level.Magnesium sulfate is a mineral that reduces seizure risks in women with preeclampsia.It is often given intravenously and can also be used to prolong pregnancy for up to two days.However, magnesium sulfate can also cause side effects and toxicity, such as respiratory depression, muscle weakness, and cardiac arrest.Therefore, the nurse should monitor the serum magnesium level to ensure that it is within the therapeutic range of 4 to 7 mg/dL.
Choice B) Serum potassium level is wrong because magnesium sulfate does not affect the potassium level significantly.
Potassium is an electrolyte that regulates the nerve and muscle function, especially the heart.
The normal range of potassium level is 3.5 to 5.0 mEq/L.
Choice C) Serum sodium level is wrong because magnesium sulfate does not affect the sodium level significantly.
Sodium is another electrolyte that helps maintain fluid balance and blood pressure.
The normal range of sodium level is 135 to 145 mEq/L.
Choice D) Serum calcium level is wrong because magnesium sulfate does not affect the calcium level significantly.
Calcium is a mineral that is important for bone health, blood clotting, and muscle contraction.
The normal range of calcium level is 8.5 to 10.2 mg/dL.
Which of the following interventions should be included in the plan of care for a client with severe preeclampsia? (Select all that apply.)
Explanation
The correct answer is choices A, B, C and D.These are all interventions that can help lower blood pressure, prevent seizures, and monitor the health of the mother and the baby in severe preeclampsia.
Choice E is wrong because continuous fetal heart rate monitoring is not necessary for severe preeclampsia unless there are signs of fetal distress or labor.Intermittent auscultation or nonstress test can be used instead to assess fetal well-being.
Normal ranges for blood pressure are below 140/90 mmHg, for urine output are 30 mL/hour or more, for platelet count are 150,000 to 450,000 per microliter, and for liver enzymes are 7 to 56 units per liter for AST and 0 to 35 units per liter for ALT.Magnesium sulfate levels should be maintained between 4 to 7 mg/dL to prevent toxicity.Fetal heart rate should be between 110 to 160 beats per minute.
Which of the following findings would indicate that a client with preeclampsia is experiencing HELLP syndrome?
Explanation
The correct answer is choice C) Elevated serum bilirubin levels.This is because bilirubin is a product of hemolysis (the breakdown of red blood cells), which is one of the components of HELLP syndrome.Elevated serum bilirubin levels indicate that there is excessive hemolysis occurring in the body, which can lead to jaundice and liver damage.
Choice A) Elevated serum creatinine levels is wrong because creatinine is a marker of kidney function, not liver function or hemolysis.While kidney failure can occur as a complication of HELLP syndrome, it is not a diagnostic criterion.
Choice B) Elevated serum uric acid levels is wrong because uric acid is also a marker of kidney function, not liver function or hemolysis.Uric acid levels can be elevated in preeclampsia, but not specifically in HELLP syndrome.
Choice D) Elevated serum glucose levels is wrong because glucose is not related to liver function or hemolysis.Glucose levels can be elevated in gestational diabetes, but not in HELLP syndrome.
Normal ranges for these tests are:
• Serum bilirubin: 0.3 to 1.2 mg/dL
• Serum creatinine: 0.6 to 1.1 mg/dL
• Serum uric acid: 2.4 to 6.0 mg/dL
• Serum glucose: 70 to 100 mg/dL
A nurse is reviewing the laboratory results of a client with gestational hypertension who has been diagnosed with HELLP syndrome.
Which of the following findings would the nurse expect to see?
Explanation
The correct answer is choice D. Hemoglobin 6 g/dL, platelets 25,000/mm3, AST 120 U/L, ALT 100 U/L.
This is because HELLP syndrome is a pregnancy complication that causes hemolysis (breaking down of red blood cells), elevated liver enzymes (indicating liver injury), and low platelet count (impairing blood clotting).
Choice A is wrong because hemoglobin 12 g/dL, platelets 150,000/mm3, AST 20 U/L, ALT 18 U/L are all within normal ranges and do not indicate HELLP syndrome.
Choice B is wrong because hemoglobin 10 g/dL, platelets 100,000/mm3, AST 40 U/L, ALT 35 U/L are mildly abnormal and may suggest mild preeclampsia but not HELLP syndrome.
Choice C is wrong because hemoglobin 8 g/dL, platelets 50,000/mm3, AST 80 U/L, ALT 70 U/L are moderately abnormal and may suggest moderate preeclampsia or incomplete HELLP syndrome but not full HELLP syndrome.
Normal ranges for these laboratory tests are:
• Hemoglobin: 11.5 to 16.5 g/dL for women.
• Platelets: 150,000 to 450,000/mm3 for adults.
• AST: 10 to 40 U/L for adults.
• ALT: 7 to 56 U/L for adults.
A nurse is administering nifedipine to a client with gestational hypertension as prescribed by the provider.
Which of the following actions would the nurse take to ensure safe administration of this medication?
Explanation
The correct answer is choice A. Check blood pressure before and after giving the medication.Nifedipine is an antihypertensive medication that is used to treat gestational hypertension.It lowers blood pressure by relaxing the blood vessels and reducing the workload of the heart.Checking blood pressure before and after giving the medication helps to monitor the effectiveness and safety of the treatment.
Choice B is wrong because grapefruit juice can interact with nifedipine and increase its blood levels, which can cause excessive lowering of blood pressure or other side effects.Grapefruit juice should be avoided when taking nifedipine.
Choice C is wrong because nifedipine does not affect the pulse rate significantly.Holding the medication if pulse rate is below 60 beats per minute is more appropriate for beta-blockers, such as labetalol, which are another class of antihypertensive medications that can slow down the heart rate.
Choice D is wrong because nifedipine does not cause hypoglycemia.Monitoring blood glucose levels for signs of hypoglycemia is more relevant for medications that lower blood sugar, such as insulin or oral antidiabetic agents.
Normal ranges for blood pressure and pulse rate during pregnancy are 110-140/60-90 mmHg and 60-100 beats per minute, respectively.Normal range for blood glucose level during pregnancy is 70-110 mg/dL.
(Select all that apply).
A nurse is providing discharge teaching to a client with gestational hypertension who delivered a healthy baby two days ago.
Which of the following statements by the client would indicate a need for further teaching?
Explanation
The correct answer is choice C. Choice C is wrong because breastfeeding is not contraindicated for women with gestational hypertension.Breastfeeding has many benefits for both the mother and the baby, and it does not affect blood pressure.
Choice A is correct because blood pressure medication should be continued as prescribed until the next check-up.Stopping medication abruptly can cause a rebound increase in blood pressure and increase the risk of complications.
Choice B is correct because headache, blurred vision, or abdominal pain are signs of severe preeclampsia, a serious complication of gestational hypertension that can affect the brain, liver, and kidneys.These symptoms should be reported to the provider immediately.
Choice D is correct because limiting salt intake and drinking plenty of fluids can help lower blood pressure and prevent fluid retention.
Salt can cause the body to hold on to excess water, which increases blood volume and blood pressure.Fluids can help flush out excess salt and keep the body hydrated.
Choice E is correct because weighing oneself daily and reporting any sudden weight gain to the provider can help monitor fluid balance and detect signs of preeclampsia.A weight gain of more than 2 pounds in a week or 5 pounds in a month may indicate fluid accumulation and increased blood pressure.
A nurse is caring for a client who has severe preeclampsia and is receiving hydralazine IV bolus for blood pressure management.
Which of the following adverse effects should the nurse monitor for? (Select all that apply.)
Explanation
The correct answer is choice A and B. Hydralazine is a drug that lowers blood pressure by relaxing the blood vessels.It can cause some side effects such astachycardia(fast heart rate) andheadache.
These are common and may go away during treatment.
However, if they are severe or persistent, the nurse should monitor the client and report to the doctor.
Choice C is wrong because nausea is not a common side effect of hydralazine.
It may be caused by other factors such as pregnancy or infection.
Choice D is wrong because hyperkalemia (high potassium level in the blood) is not a side effect of hydralazine.
It may be caused by other drugs such as angiotensin-converting enzyme inhibitors or potassium-sparing diuretics.
Choice E is wrong because oliguria (low urine output) is not a side effect of hydralazine.
It may be a sign of kidney damage or dehydration.
The nurse should monitor the client’s fluid intake and output and report any changes to the doctor.
A nurse is reviewing laboratory results for a client who has HELLP syndrome.
Which of the following findings should the nurse expect? (Select all that apply.)
Explanation
The correct answer is choice A, B, C and D.These choices reflect the laboratory findings that are expected in a client who has HELLP syndrome.HELLP syndrome is a rare pregnancy complication that is a type of preeclampsia and has similar symptoms.It can cause serious blood and liver problems.
Choice A is correct because hemoglobin of 9 g/dL indicates hemolysis, which is the breaking down of red blood cells.The normal range of hemoglobin for pregnant women is 11 to 16 g/dL.
Choice B is correct because platelets of 90,000/mm3 indicate thrombocytopenia, which is a low platelet count.The normal range of platelets for pregnant women is 150,000 to 400,000/mm3.
Choice C is correct because AST of 120 U/L indicates elevated liver enzymes, which reflect liver injury.The normal range of AST for pregnant women is 10 to 40 U/L.
Choice D is correct because LDH of 600 U/L indicates elevated lactate dehydrogenase, which is a marker of hemolysis.The normal range of LDH for pregnant women is 140 to 280 U/L.
Choice E is wrong because WBC of 15,000/mm3 indicates leukocytosis, which is not a feature of HELLP syndrome.The normal range of WBC for pregnant women is 5,000 to 15,000/mm3.
A nurse is preparing to administer an IV loading dose of magnesium sulfate to a client who has preeclampsia with severe features.
Which of the following actions should the nurse take?
Explanation
The correct answer is choice D. Have calcium gluconate available at the bedside as an antidote.Magnesium sulfate is used to prevent and treat seizures in women with severe preeclampsia or eclampsia.However, it can also cause toxicity and respiratory depression if the serum level is too high.Calcium gluconate is the antidote for magnesium sulfate toxicity and should be readily available at the bedside.
Choice A is wrong because the medication should be administered over 20-30 minutes using an infusion pump.
A shorter infusion time may increase the risk of adverse effects.
Choice B is wrong because the client should be placed in a lateral position to improve uteroplacental perfusion and reduce the risk of aspiration.
Choice C is wrong because the client’s blood pressure should be monitored every 5 minutes during the infusion, not every 15 minutes.
Blood pressure is an indicator of the severity of preeclampsia and the effectiveness of magnesium sulfate therapy.
A nurse is caring for a client with gestational hypertension who is at risk for developing preeclampsia.
Which of the following interventions should the nurse implement to prevent this complication? (Select all that apply.).
Explanation
The correct answer is choice A, C and D.These interventions can help prevent or delay the development of preeclampsia by reducing blood pressure, monitoring fetal well-being and assessing for signs of worsening condition.
Choice B is wrong because corticosteroids are not used to prevent preeclampsia, but to enhance fetal lung maturity in case of preterm delivery.
Choice E is wrong because a diet high in protein and low in carbohydrates is not recommended for gestational hypertension or preeclampsia.A balanced diet with adequate calcium, magnesium and antioxidants is advised.
A nurse is evaluating the effectiveness of magnesium sulfate therapy for a client with severe preeclampsia who is in labor.
Which of the following findings would indicate that the therapy is effective?
Explanation
The correct answer is choice B. The client’s urine output is at least 30 mL/hr.This indicates that the therapy is effective because magnesium sulfate can cause renal impairment and fluid retention, which can worsen the condition of preeclampsia.
A normal urine output is a sign that the kidneys are functioning well and that the fluid balance is maintained.
Choice A is wrong because the client’s blood pressure may not normalize even with magnesium sulfate therapy.
Magnesium sulfate is mainly used to prevent seizures, not to lower blood pressure.Other antihypertensive medications may be needed to control blood pressure in severe preeclampsia.
Choice C is wrong because the client’s deep tendon reflexes are expected to decrease with magnesium sulfate therapy, as it is a central nervous system depressant.
A normal reflex response is 2+, but a lower response (1+ or 0) may indicate magnesium toxicity, which can cause respiratory depression, cardiac arrest, and coma.
Choice D is wrong because the client’s respiratory rate should be monitored closely with magnesium sulfate therapy, as it can also cause respiratory depression.
A normal respiratory rate is 12 to 20 breaths per minute, but a lower rate (less than 12) may indicate magnesium toxicity, which requires immediate treatment with calcium gluconate.
A nurse is reviewing the risk factors for gestational hypertension with a group of pregnant clients at a prenatal clinic.
Which of the following factors should the nurse include? (Select all that apply.).
Explanation
The correct answer is choice A, B, C and E.These are all risk factors for gestational hypertension according to various sources.
Some possible explanations for each choice are:
• Choice A: Maternal age over 35 years.Older women are more likely to have chronic hypertension, diabetes, or other conditions that increase the risk of gestational hypertension.
• Choice B: First pregnancy.Women who are pregnant for the first time are more likely to develop gestational hypertension than women who have had previous pregnancies.
• Choice C: Multiple gestation.Women who are carrying twins, triplets, or more are more likely to have gestational hypertension because of the increased placental mass and blood volume.
• Choice D: History of diabetes mellitus.This is not a risk factor for gestational hypertension, but it is a risk factor for preeclampsia, which is a more severe form of hypertension that involves proteinuria and organ damage.
Preeclampsia can develop from gestational hypertension or occur independently.
• Choice E: African American race.African American women are more likely to have gestational hypertension than women of other races or ethnicities.
This may be due to genetic, environmental, or social factors that affect blood pressure regulation.
Normal ranges for blood pressure during pregnancy are less than 140/90 mmHg.Gestational hypertension is diagnosed when blood pressure is greater than or equal to 140/90 mmHg after 20 weeks of pregnancy and there is no proteinuria or other signs of preeclampsia.Gestational hypertension usually goes away after delivery, but it can increase the risk of complications for both the mother and the baby.
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