Exam (elaborations)

NURS U340 STUDY QUESTIONS AND ANSWERS

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Course
NURS U340

Institution
University Of Arizona College Of Nursing

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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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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