Hypertensive Medications
This calcium channel blocker is used to treat elevated blood pressures. Recommended treatment if IV access has not been obtained. Dosage is 10mg PO.
Nifedipine
These are best practices for blood pressure measurement.
Sitting with feet on the floor, legs uncrossed, after resting, and using an appropriate size BP cuff
Preeclampsia occurs most often after what point in pregnancy.
>20 weeks
Preeclampsia originates from what organ.
Placenta
*Rationale: Preeclampsia involves abnormal formation of blood vessels/arteries carrying blood to the placenta.
“This is the loading/initial dose of Magnesium Sulfate to be given for Preeclampsia."
4-6g IV bolus over 20 minutes
This beta blocker is used to treat elevated B/P; contraindicated in patients with history of asthma or first degree heart block.
Labetalol
These precautions should be taken for a patient with a hypertensive diagnosis: oxygen, oral airway, suction, & padded side rails.
Seizure precautions
This lab test can indicate kidney function issues in patients with preeclampsia.
Protein Urine Test
Multiple gestations INCREASES or DECREASES the risk of preeclampsia?
Increases
This is the maintenance magnesium sulfate dose to be administered.
1-2 g/hr
This vasodilator is used for severe B/P elevation. Side effects include: flushing, headache, maternal or fetal tachycardia, palpitations, and uteroplacental insufficiency
Hydralazine
Patients should be educated that preeclampsia can still occur up to this amount of time after delivery.
6 weeks
These are symptoms of Preeclampsia.
B/P >140/90, 20+ weeks pregnant, proteinuria, rapid weight gain, significant swelling in face, hands, and/or feet.
Smokers have a lower or higher risk of preeclampsia?
Lower
When giving Magnesium sulfate, we should monitor for the following side effects.
Nausea, flushing, visual disturbances, respiratory depression, pulmonary edema.
This medication is contraindicated in the treatment of preeclampsia.
Ace Inhibitors
*Rationale: They're contraindicated during the 2nd and 3rd trimesters of pregnancy because of increased risk of fetal renal damage
Patients should be educated about the importance of monitoring this organ function, which can be affected by preeclampsia.
Kidney function
Pt B/P's are as follows: 145/85,148/92, 150/88, 138/94. 30 weeks pregnant. Denies HA, epigastric pain or changes in vision. DTRs +2, no clonus, labs WNL. She is likely experiencing what?
Gestational Hypertension
What percentage of pregnancies are complicated by preeclampsia?
5-8% (or roughly 1 in 12 pregnancies)
These are signs of magnesium toxicity.
Loss of DTR's, RR <12/min, urine output < 30mL/hr, changes in LOC.
This medication is the preferred drug of choice in the prevention of eclampsia.
Magnesium Sulfate
Postpartum preeclampsia discharge instructions should include: return to the hospital if any SOB, visual changes, epigastric pain, or more than 2 blood pressures greater than this number.
160/110
Presenting patient symptoms: 37 weeks pregnant. HA, unresolved with medication. Blood pressures of 165/100, 162/98, 174/96, 170/104. DTRs +3, & clonus in hands. After IV placement, begins seizing.
Eclampsia
This is a life-threatening form of preeclampsia occurring when the patient develops multiple organ damage.
HELLP Syndrome
This is the antidote for magnesium toxicity.
Calcium Gluconate