高血压英文ppt精品课件structural disorders fetal demise intrauterine fetal

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1、StructuralDisordersFetalDemise/IntrauterineFetalDeathDEFINITION:DeathofafetusaftertheageofviabilityInterventionsandNursingCareAllowpatienttodecidewhenshewantstodeliverMostwomengointolaborontheirownin2weeks,somaywaitforlabortobeginspontaneouslyInducelaborProstaglandin(ProstinE)causessmo

2、othmusclestocontract:Sideeffects-nausea,vomiting,diarrheaCytogelProvidewithEmotionalSupport,allowtoholdbabyAssessment:1.FirstindicationisusuallyNOfetalmovement2.NOfetalhearttonesConfirmedbyultrasound3.DecreaseinthesignsandsymptomsofpregnancyPREGNANCYINDUCEDHYPERTENSIONAhypertensivedise

3、aseofpregnancy.Knownaspre-eclampsiaandeclampsia.Pre-eclampsia=hypertension,proteinuria,edemaEclampsia=othersignsplusconvulsionsItdevelopsbetweenthe20thand24thweekofgestationanddisappearsafterthetenthdaypostpartumPREDISPOSINGFACTORSPRIMIGRAVIDAMULTIPLEPREGNANCYVASCULARDISEASEUNDER17ANDO

4、VER35LOWERSOCIOECONOMICSTATUSSeveremalnutrition,decreaseProteinintakeInadequateorlateprenatalcareFAMILYHISTORYHYDATIFORMMOLEDiabetes,renalPATHOLOGICALCHANGESPIHisdueto:GENERALIZEDARTERIOLARCYCLICVASOSPASMSINCREASEDPERIPHERALRESISTANCE;IMPEDEDBLOODFLOW(inbloodpressure)EndothelialCELLDAM

5、AGEIntravascularFluidRedistribution(decreaseindiameterofbloodvessel)DecreasedOrganPerfusionMulti-systemfailureDiseaseClinicalManifestationsClinicalManifestationHYPERTENSIONEarliestandTheMostDependableIndicatorofPIHHypertensionB/P=140/90ifhavenobaseline.1.30mm.Hg.systolicincreaseora15

6、mm.Hg.diastolicincrease(twooccasionsfourtosixhoursapart)2.IncreaseinMAP>20mm.Hgoverbaselineor>105mm.Hg.withnobaselinePositiveRollOverTestRationaleforHYPERTENSIONThebloodpressurerisesdueto:ARTERIOLARVASOSPASMSANDVASOCONSTRICTIONcausing(Narrowingofthebloodvessels)anincreaseinperipheralre

7、sistancefluidforcedoutofvesselsHEMOCONCENTRATIONIncreasebloodviscosity=IncreasedhematocritKeyPointtoRemember!HEMOCONCENTRATIONdevelopsbecause:VesselsbecamenarrowedforcingfluidtoshiftFluidleavestheintracellularspacesandmovestoextracellularspacesNowthebloodviscosityisincreased(Hemocrit