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1.5 CE Test Hours

Gestational Hypertension, Preeclampsia, and Peripartum Cardiomyopathy

A Clinical Review

Contrada, Emily

AJN, American Journal of Nursing: November 2019 - Volume 119 - Issue 11 - p 41
doi: 10.1097/01.NAJ.0000605356.14571.89
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TEST INSTRUCTIONS

  • Read the article. Take the test for this CE activity online at www.nursingcenter.com/ce/ajn.
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  • There is only one correct answer for each question. The passing score for this test is 13 correct answers. If you pass, you can print your certificate of earned contact hours and the answer key. If you fail, you have the option of taking the test again at no additional cost.
  • For questions, contact LPD: 1-800-787-8985.
  • Registration deadline is September 3, 2021.

PROVIDER ACCREDITATION

LPD will award 1.5 contact hours for this continuing nursing education (CNE) activity. LPD is accredited as a provider of CNE by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.5 contact hours. LPD is also an approved provider of CNE by the District of Columbia, Georgia, and Florida #50-1223. Your certificate is valid in all states.

PAYMENT

The registration fee for this test is $17.95.

Gestational Hypertension, Preeclampsia, and Peripartum Cardiomyopathy: A Clinical Review

GENERAL PURPOSE

To present information about pregnancy-specific cardiovascular diseases.

LEARNING OBJECTIVES/OUTCOMES:

After completing this continuing education activity, you should be able to

  • summarize the pathophysiology and classic features of certain pregnancy-specific cardiovascular diseases.
  • plan appropriate assessment and interventions for pregnant women who have such diseases.
  1. During normal pregnancy, blood pressure tends to
    1. decrease slightly, especially during the first trimester.
    2. increase slightly, especially during the third trimester.
    3. increase slightly across all 3 trimesters.
  2. During normal pregnancy, from the first to the third trimester, activation of the renin–angiotensin–aldosterone system causes
    1. a decrease in venous return.
    2. an increase in blood volume.
    3. a decrease in cardiac preload.
  3. Gestational hypertension is diagnosed
    1. at about 14 to 16 weeks, when the average blood pressure is at least 130/80 mmHg.
    2. after 20 weeks, when the average blood pressure is at least 130/80 mmHg.
    3. after 20 weeks, when the average blood pressure is at least 140/90 mmHg but there are no manifestations of preeclampsia.
  4. For diagnostic purposes, clinicians should measure a pregnant woman's blood pressure in a clinical setting twice,
    1. with at least 4 hours between measurements.
    2. using the arm with the lowest values.
    3. with at least 2 hours between measurements.
  5. Gestational hypertension has been associated with higher risk of developing which of the following later in life?
    1. lung disease
    2. kidney disease
    3. immune system disorders
  6. Preeclampsia can be diagnosed after 20 weeks of gestation when there is new-onset hypertension with either proteinuria or indications of target organ dysfunction. The latter may include which of the following manifestations?
    1. blurred vision
    2. dehydration
    3. polyuria
  7. Which of the following findings indicates proteinuria?
    1. 100 mg of protein in a 24-hour urine excretion sample
    2. 200 mg of protein in a 24-hour urine excretion sample
    3. a protein-to-creatinine ratio in two urine samples of 0.5 mg/dL
  8. Untreated, preeclampsia can progress to eclampsia, as defined by the onset of
    1. seizures.
    2. dyspnea.
    3. chest pain.
  9. The H in the acronym for HELLP syndrome stands for
    1. headache.
    2. hemolysis.
    3. hemoptysis.
  10. Peripartum cardiomyopathy is now thought to
    1. occur in association with another cardiovascular disease (CVD).
    2. be a silent underlying dilated cardiomyopathy.
    3. be a distinct idiopathic cardiomyopathy.
  11. Women at higher risk for pregnancy-specific CVDs include those who
    1. are of European descent.
    2. are overweight or obese.
    3. have thyroid disease.
  12. Symptoms of liver disorders resulting from preeclampsia include
    1. shoulder pain.
    2. lower back pain.
    3. upper left quadrant pain.
  13. Women who have peripartum cardiomyopathy require monitoring for manifestations of heart failure consistent with volume overload and systemic hypoperfusion, including
    1. dry mouth.
    2. productive cough.
    3. paroxysmal nocturnal dyspnea.
  14. Which of the following types of exercise is contraindicated in women with pregnancy-induced hypertension, preeclampsia, HELLP, and hemodynamically significant heart disease?
    1. weight training
    2. aerobic exercise
    3. isometric exercise
  15. First-line pharmacotherapy for gestational hypertension during the antepartum phase typically involves prescribing labetalol or
    1. methyldopa.
    2. amlodipine.
    3. enalapril.
  16. During the intrapartum phase, clinicians should do which of the following for a patient with gestational hypertension?
    1. Prepare her for a cesarean section.
    2. Administer a high-ceiling diuretic.
    3. Position her in a left lateral position.
  17. With patients who are given magnesium sulfate, it's essential to monitor for signs of magnesium toxicity, which include
    1. oliguria.
    2. tachypnea.
    3. tachycardia.
  18. When a woman with peripartum cardiomyopathy is in the intrapartum phase and is mildly unstable, which of the following interventions is recommended?
    1. general anesthesia
    2. planned cesarean section
    3. continuous spinal anesthesia
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