APPENDICES

Pregnancy Induced Hypertension (PIH) is a condition in which

vasospasms occur during pregnancy in both small and large arteries.
Signs of Hypertension, Proteinuria, and Edema develop.

Anatomy and Physiology:

Most simply stated, the major function of the cardiovascular system is transportation. Using
blood as the transport vehicle, the system carries oxygen, nutrients, cell wastes, hormones, and
many other substances vital for body homeostasis to and from the cells. The force to move the
blood around the body is provided by the beating heart. The cardiovascular system can be
compared to a muscular pump equipped with one-way valves and a system of large and small
plumbing tubes within which the blood travels.

HEART:

The heart is a muscular organ found in all vertebrates that is responsible for pumping blood
throughout the blood vessels by repeated, rhythmic contractions.
The heart is enclosed in a double-walled sac called the pericardium. The superficial part of this
sac is called the fibrous pericardium. This sac protects the heart, anchors its surrounding
structures, and prevents overfilling of the heart with blood. It is located anterior to the vertebral
column and posterior to the sternum. The size of the heart is about the size of a fist and has a
mass of between 250 grams and 350 grams. The heart is composed of three layers, all of which
are rich with blood vessels. The superficial layer, called the visceral layer, the middle layer,
called the myocardium, and the third layer which is called the endocardium. The heart has four
chambers, two superior atria and two inferior ventricles. The atria are the receiving chambers
and the ventricles are the discharging chambers. The pathway of blood through the heart consists
of a pulmonary circuit and a systemic circuit. Blood flows through the heart in one direction,
from the atrias to the ventricles, and out of the great arteries, or the aorta for example. This is
done by four valves which are the tricuspid atrioventicular valve, the mitral atrioventicular valve,
the aortic semilunar valve, and the pulmonary semilunar valve.
Systemic circulation is the portion of the cardiovascular system which carries oxygenated blood
away from the heart, to the body, and returns deoxygenated blood back to the heart. The term is
contrasted with pulmonary circulation.

Pulmonary circulation is the portion of the cardiovascular system which carries oxygen-
depleted blood away from the heart, to the lungs, and returns oxygenated blood back to the heart.
The term is contrasted with systemic circulation. A separate system known as the bronchial
circulation supplies blood to the tissue of the larger airways of the lung.

Arteries are blood vessels that carry blood away from the heart. All arteries, with the exception
of the pulmonary and umbilical arteries, carry oxygenated blood.
Pulmonary arteries
The pulmonary arteries carry deoxygenated blood that has just returned from the body to the
heart towards the lungs, where carbon dioxide is exchanged for oxygen.

Systemic arteries
Systemic arteries can be subdivided into two types – muscular and elastic – according to the
relative compositions of elastic and muscle tissue in their tunica media as well as their size and
the makeup of the internal and external elastic lamina. The larger arteries (>10mm diameter) are
generally elastic and the smaller ones (0.1-10mm) tend to be muscular. Systemic arteries deliver
blood to the arterioles, and then to the capillaries, where nutrients and gasses are exchanged.

The Aorta
The aorta is the root systemic artery. It receives blood directly from the left ventricle of the heart
via the aortic valve. As the aorta branches, and these arteries branch in turn, they become
successively smaller in diameter, down to the arteriole. The arterioles supply capillaries which in
turn empty into venules. The very first branches off of the aorta are the coronary arteries, which
supply blood to the heart muscle itself. These are followed by the branches off the aortic arch,
namely the brachiocephalic artery, the left common carotid and the left subclavian arteries.

Aorta the largest artery in the body, originating from the left ventricle of the heart and extends
down to the abdomen, where it branches off into two smaller arteries (the common iliacs). The
aorta brings oxygenated blood to all parts of the body in the systemic circulation.

The aorta is usually divided into five segments/sections:

• Ascending aorta—the section between the heart and the arch of

aorta
• Arch of aorta—the peak part that looks somewhat like an inverted
"U"
• Descending aorta—the section from the arch of aorta to the point
where it divides into the common iliac arteries
o Thoracic aorta—the half of the descending aorta above the diaphragm
o Abdominal aorta—the half of the descending aorta below the
diaphragm

Arterioles
Arterioles, the smallest of the true arteries, help regulate blood pressure by the variable
contraction of the smooth muscle of their walls, and deliver blood to the capillaries.
Veins are blood vessels that carry blood towards the heart. Most veins carry deoxygenated blood
from the tissues back to the lungs; exceptions are the pulmonary and umbilical veins, both of
which carry oxygenated blood. Veins differ from arteries in structure and function; for example,
arteries are more muscular than veins and they carry blood away from the heart.
Veins are classified in a number of ways, including superficial vs. deep, pulmonary vs. systemic,
and large vs. small.
Superficial veins
Superficial veins are those whose course is close to the surface of the body, and have no
corresponding arteries.

Deep veins
Deep veins are deeper in the body and have corresponding arteries.

Pulmonary veins
The pulmonary veins are a set of veins that deliver oxygenated blood from the lungs to the heart.

Systemic veins
Systemic veins drain the tissues of the body and deliver deoxygenated blood to the heart.
Atrium sometimes called auricle, refers to a chamber or space. It may be the atrium of the lateral
ventricle in the brain or the blood collection chamber of a heart. It has a thin-walled structure that
allows blood to return to the heart. There is at least one atrium in animals with a closed
circulatory system.

Right atrium is one of four chambers (two atria and two ventricles) in the human heart. It
receives deoxygenated blood from the superior and inferior vena cava and the coronary sinus,
and pumps it into the right ventricle through the tricuspid valve. Attached to the right atrium is
the right auricular appendix.

Left atrium is one of the four chambers in the human heart. It receives oxygenated blood from
the pulmonary veins, and pumps it into the left ventricle, via the atrioventricular valve.
Ventricle is a chamber which collects blood from an atrium (another heart chamber that is
smaller than a ventricle) and pumps it out of the heart.
Right ventricle is one of four chambers (two atria and two ventricles) in the human heart. It
receives deoxygenated blood from the right atrium via the tricuspid valve, and pumps it into the
pulmonary artery via the pulmonary valve and pulmonary trunk.

Left ventricle is one of four chambers (two atria and two ventricles) in the human heart. It
receives oxygenated blood from the left atrium via the mitral valve, and pumps it into the aorta
via the aortic valve.

Medications used:

• Magnesium Sulfate - muscle relaxant, prevent seizures

• Hydrazaline (Apresoline)- anti hypertensive (peripheral vasodilator) use to

decrease hypertension
 • Diazepam (Valium)- halt seizures

• Calcium Gluconate- antidote for Magnesium Sulfate

Nursing Assessment
- Nursing assessment is the gathering of information about a
patient's physiological, psychological, sociological, and spiritual status.
The way in which a nurse gathers and evaluates data about a client (individual,
family, or community). The assessment includes a physical examination,
interviewing, and observations. Assessment is also the first step in the nursing
process.

Physical Assessment – (Cephalocaudal)

• Head and Scalp Eyes

• Nose Ears
• Mouth and Teeth Neck
• Breast Skin
• Back Rectum
• Extremities

BLOOD HEMATOLOGY:

Hemoglobin (Hgb)- a hemoprotein composed of globin and heme that gives

red blood cells their characteristic color; function primarily to transport oxygen
from the lungs to the body tissues
Hematocrit (Hct)- The hematocrit (Ht or HCT) or packed cell volume (PCV)
or erythrocyte volume fraction (EVF) is the proportion of blood volume that is
occupied by red blood cells.
WBC- blood cells, which fight infections. The normal count is 5000-10000.