Student Nurse Laura

Orem – "creative effort of one human being to help another human being."

Classification of Hypertensive States of Pregnancy

Posted by Laura on January 23, 2010

 .doc

Hypertension is defined as a systolic BP greater than 140mm Hg or a diastolic BP greater than 90 mm Hg. There must be 2 measurements at least 4-6 hours apart for diagnosis.

Proteinuria is a concentration of >30 mg/dl in a random urine specimen, or >300 mg/24 hours (preferred method).

Pathologic edema + generalized accumulation of fluid of the face, hands, or abdomen not responsive to 12 hours of bed rest –  or rapid weight gain of more than 2kg in 1 week. (this is no longer considered a diagnostic of preeclampsia alone)

Preeclampsia progresses from mild to severe preeclampsia, to HELLP syndrome or eclampsia.

Severe preeclampsia

  • systolic 160 or diastolic 110by laura barron
  • proteinuria > 2g in 24 hr
  • oliguria < 500 ml / 24 hrs
  • ALOC
  • hepatic involvement
  • thrombocytopenia w/platelet  < 100,00/mm3
  • pulmonary edema or cyanosis
  • fetal growth restriction

HELLP syndrome

  • H – hepatic dysfunction characterized by hemolysis
  • EL – elevated liver enzymes
  • LP – low platelets < 100,000/mm3

Lab Tests: Blood

  • CBC (including a platelet count)
  • clotting studies (bleeding time, PT, PTT, fibrinogen)
  • Liver enzymes (lactate dehydrogenase LDH, AST, ALT
  • Chemistry panel (BUN, creatine, glucose, uric acid
  • Type and screen

    Urine

  • volume of at least 30 ml/hr, or 120 ml/4 hr
  • Proteinuria

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