OB Inpatient Certification Test
The [_____] is considered the pathogenic focus for all manifestations of pre-e Correct Answer: Placenta
(Regarding Pre-e): Increased sensitivity to Angiotensin II leads to [-------
...
OB Inpatient Certification Test
The [_____] is considered the pathogenic focus for all manifestations of pre-e Correct Answer: Placenta
(Regarding Pre-e): Increased sensitivity to Angiotensin II leads to [-------] and [------] Correct Answer: Vascular damage & arteriolar vasoconstriction and systemic vasospasm
A [---------] measurement is recommended for all pregnant women with HTN Correct Answer: 24-hr urinary protein measurement
Thrombocytopenia is present when platelets are low: [-------], and severe: [------] Correct Answer: Low platelets: less than 100,000/mm3, severe platelets: less than 50,000/mm3
In severe pre-e, urine output decreases to less than [---]ml in 24hrs Correct Answer: 400ml
(Regarding pre-e): Arteriolar vasospasms damage the [-----] layer of small blood vessels, causing lesions --> [-----] accumulate at lesions sites and fibrin network forms--> RBCs are forced through the network under high pressure, resulting in [------] Correct Answer: Arteriolar vasospasms damage the endothelial layer..... platelets accumulate at lesions..... resulting in hemolysis
With regards to HELLP, Hemolysis can be identified by looking for (4): Correct Answer:
1) falling hematocrit
2) hyperbilirubinemia (>1.2mg/dl)
3) Increased LDH
4) Jaundice including sclerae
With regards to HELLP, Elevated Liver Enzymes can be identified by looking for (5): Correct Answer:
1) Increased LDH
2) Increased AST/ALT
3) Feeling Malaise
4) Viral-like symptoms
5) RUQ pain
With regards to HELLP, Low Platelets can be identified by looking for (2): Correct Answer:
1) falling platelet count (low: <100,000, severe: <50,000)
2) Abnormal coagulation and fibrinolytic values
You do not need to diagnose [-------] in order to diagnose HELLP Correct Answer: Preeclampsia
The definitive treatment of for preeclampsia is .... Correct Answer: delivery
The primary goals of management of pre-e are: (4) Correct Answer:
1) Prevent convulsions through use of Mag Sulfate
2) Ensure adequate kidney functions
3) Monitor fetal status continuously for signs of uteroplacental insufficiency
4) To stabilize the women so vaginal/cesarean birth can be accomplished
A women with preeclampsia might experience a reduced plasma volume, and a [--------] diet can worsen the situation Correct Answer: a salt-restricted diet
In nursing management of a women with preeclampsia, BPs should be ..... Correct Answer: taken in the same position on the left arm, horizontal with the heart
In nursing management of a women with preeclampsia, oliguria is [-------] and is an [-----] sign Correct Answer: oliguria is output less than 30ml/hr for 2hrs.... and is an ominous sign
In nursing management of a women with preeclampsia, limit fluid administration to no more than [-----] or [--]ml/kr/hr Correct Answer: no more than 150ml/hr, or 1ml/kg/hr
Magnesium sulfate is given for [-------] therapy, it is note given to treat [------] Correct Answer: Magnesium sulfate is given for anticonvulsant therapy, not to treat hypertension
The therapeutic range of magnesium sulfate is between [-------] Correct Answer: between 4 to 7 mEq/L
The antidote to Magnesium toxicity is [-----] Correct Answer: Calcium gluconate
Current recommendations for antihypertensive therapy include these 3 medications: Correct Answer: 1) Hydralazine (Apresoline- arteriolar dilator)
2) Labetalol (Adrenergic blocker)
3) Nifedipine (Calcium entry blocker)
The preeclamptic women maintained on therapeutic levels of Mag Sulfate is at risk for [-------] after delivery, this is of great concern because she is already experiencing reduced [----] and [-----] Correct Answer: At risk for postpartum hemorrhage after delivery... she is already experiencing reduced blood volume and hemoconcentration
HTN during the last 20weeks of pregnancy or in the first 24hrs postpartum without other signs of preeclampsia Correct Answer: Transient Hypertension
A term sometimes used to designate expectant women who have elevated BP after 20 weeks but without accompanying proteinuria Correct Answer: Gestational Hypertension
A subset of preeclampsia Correct Answer: HELLP syndrome
Sometimes seen in normotensive women within the first hours after delivery but with a subsequent return to baseline BP levels within 24 hrs. Correct Answer: Transient Hypertension
The development of a BP higher than 140/90 mmHG or higher after the 20th week of pregnancy and accompanied by proteunuria Correct Answer: Preeclampsia
Occurs before the 20th week of gestation in the presence of pathologic changes in the placenta Correct Answer: Preeclampsia
A disorder that can begin with implantation, but has no overt signs or symptoms for weeks or even months Correct Answer: Preeclampsia
Exists in a severe form when BP reaches 160/110 mmHg or higher Correct Answer: Preeclampsia
Can occur in women who enter pregnancy with preexisting HTN Correct Answer: Superimposed Preeclampsia
Has as its underlying pathophysiology arterial vasospasm leading to microangiopathic hemolytic anemia Correct Answer: HELLP Syndrome
Is accompanied by convulsions nots caused by neurologic disease Correct Answer: Eclampsia
Is diagnosed with a history of persistent BP elevation of at least 140/90 mmHG before the 20th week of gestations Correct Answer: Chronic hypertension
Convulsions can occur in the presence of mildly elevated BP or mild preteinuria Correct Answer: Ecplamsia
The presence of this hypertensive disorder, together with DM, renal disease, or a cardiac condition, increases the mother's risk Correct Answer: Chronic hypertension
[--]% of all adolescent and adult HIV infections worldwide are the result of heterosexual transmission Correct Answer: 90%
HIV-1 is predominate in [----] and HIV-2 is predominate in [-----]. Correct Answer: HIV-1 in American, HIV-2 in West Africa
The impact of the HIV infection is related to its effect on the normal function of [-----] cells. These cells play an essential role in orchestrating the body's [-----]. Correct Answer: The normal function of CD4+T cells, which play an important role in the body's immune function.
The standard algorithm for HIV testing consists of:
1) an initial screening with a sensitive [--------]
2) followed by confirmation with the [------] Correct Answer:
1) An initial screening with the EIA (enzyme immunosorbent assay)
2) Followed by confirmation with the Western blot test
The average time to develop detectable HIV antibodies to provide results with the EIA test is [----] Correct Answer: 25 days
Western blot tests are reported as,
1) Unequivocal positive: [---]
or 2) Indeterminate: [----] Correct Answer:
1) Unequivocal positive: HIV infected-- the antibody-positive serum reacts with all nine viral antigens
2) Indeterminate: not enough detectable antibodies, recommended to retest in 1 month, until 6mos-- indeterminate for >6mo = not HIV positive
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