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From pregnancy to renal disease

Understanding preeclampsia

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doi: 10.1097/01.NURSE.0000651804.03122.8e
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INSTRUCTIONS From pregnancy to renal disease: Understanding preeclampsia


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From pregnancy to renal disease: Understanding preeclampsia

GENERAL PURPOSE: To provide information about preeclampsia and its renal implications. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Describe the risk factors for preeclampsia. 2. Identify the hallmark features of preeclampsia. 3. Outline treatment recommendations for patients with preeclampsia.

  1. Preeclampsia typically develops after
    1. 12 weeks gestation.
    2. 18 weeks gestation.
    3. 20 weeks gestation.
  2. One risk factor for preeclampsia is
    1. obesity.
    2. maternal age over 20.
    3. single-fetus pregnancy.
  3. Hallmark features of preeclampsia include hypertension and
    1. thrombocytopenia.
    2. proteinuria.
    3. elevated liver transaminase levels.
  4. An indicator of proteinuria in pregnancy is a
    1. serum creatinine of <1.1 mg/dL.
    2. urine protein dipstick of 2+.
    3. protein-to-creatinine ratio of 0.1 or less.
  5. Patients with gestational hypertension without proteinuria are considered preeclamptic if they have
    1. pulmonary edema.
    2. thrombocytosis.
    3. a systolic BP of 140 mm Hg or more.
  6. Even after maternal stabilization, delivery of the fetus is recommended when preeclampsia with severe features is diagnosed at or beyond
    1. 20 weeks gestation.
    2. 28 weeks gestation.
    3. 34 weeks gestation.
  7. Which of the following is an accurate description of CKD?
    1. a gradual irreversible loss of kidney function over time
    2. abnormal kidney function present for more than 20 weeks
    3. eGFR greater than 60 mL/min/1.73 m2 for 3 or more months
  8. The percentage of patients diagnosed with CKD who develop ESRD is
    1. 3%.
    2. 25%.
    3. 90%.
  9. In the case study, MK's provider believed that she developed renal disease due to preeclampsia superimposed on underlying
    1. thrombocytopenia.
    2. chronic hypertension.
    3. elevated liver transaminases.
  10. Inform patients about warning signs for preeclampsia such as
    1. sudden weight loss.
    2. leg cramps.
    3. persistent severe headache.
  11. In CKD, decreased erythropoietin production results in
    1. hypocalcemia.
    2. acidosis.
    3. anemia.
  12. Which medication is thought to have a protective effect for women at high risk for preeclampsia?
    1. methyldopa
    2. betamethasone
    3. low-dose aspirin
  13. Treatment with an antihypertensive drug is initiated in patients with a
    1. diastolic BP of 90 mm Hg or more.
    2. diastolic BP of 110 mm Hg or more.
    3. systolic BP of 140 mm Hg or more.
  14. Acute-onset severe hypertension may be treated initially with
    1. I.V. hydralazine.
    2. oral methyldopa.
    3. oral diltiazem.
  15. What is prescribed to prevent seizures in patients with preeclampsia with severe features?
    1. methyldopa
    2. magnesium sulfate
    3. labetalol
  16. If the patient's BP is well controlled with no signs or symptoms of severe disease, how often should her BP be assessed during the first week postpartum?
    1. every 8 hours
    2. every other day
    3. every 3 days
  17. After delivery, the patient should be referred to a specialist if hypertension persists for more than
    1. 1 week postpartum.
    2. 3 weeks postpartum.
    3. 6 weeks postpartum.
  18. If BP has normalized, the patient may begin using oral contraceptives that combine estrogen and progestin
    1. 1 week postpartum.
    2. 2 to 3 weeks postpartum.
    3. 4 to 6 weeks postpartum.
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