Med Mania
Magnesium Sulfate is used for what purpose in Preeclamsia management?
Seizure prophylaxis
Blurry vision is a result of swelling here
The brain or cerebrum
What should you suspect when you observe loss of patellar reflexes, slurred speech and muscular paralysis.
Magnesium sulfate toxicity
Describe what symptoms are typically seen with preeclampsia?
Worsening headache, epigastric pain, visual disturbances, increasing edema, decreasing urinary output, N/V, disorientation, bleeding gums
What lab tests can be done to detect proteinuria?
24 hour urine
Spot urine:protein creatinine
Urine dip (in office setting)
Why do we administer antihypertensives for preeclampsia?
To prevent stroke
RUQ or epigastric pain in preeclampsia originates in this organ
The Liver
A women presents at her 14 week appointment with blood pressure 145/90. What would you diagnose her with?
Chronic HTN
The difference between preeclampsia and gestational hypertension
The presence of proteinuria
In preeclampsia, what other labs besides proteinuria are being monitored?
Liver enzymes (AST/ALT)
Platelets
Creatinine
What are the recommended antihypertensives for severe blood pressure ranges?
Labetalol, hydralazine, oral nifedipine
What happens to the uterine spiral arterioles in preeclampsia?
Vasoconstriction
What medication can be given to women with a history of preeclampsia with severe features to decrease the risk in the current pregnancy?
Low-dose Aspirin
What antenatal testing would you anticipate in a women with Gest. HTN or preeclampsia?
NST
(1-2 times weekly)
What platelet level demonstrates thrombocytopenia?
Less than 100,000
What is the antidote for Magnesium toxicity?
Calcium Gluconate
What is it called when clotting components are exhausted and bleeding complications ensue?
DIC
(Disseminated Intravascular Coagulation)
Auscultation of all lung fields every two hours while on mag sulfate is to detect this complication of preeclampsia.
Pulmonary Edema
Recommended postpartum follow up care for women diagnosed with Gest. HTN, preeclampsia, or superimposed preeclampsia
What is 72 hours and again 7-10 days postpartum
The amount of protein present in a 24 hour urine to be considered diagnostic for preeclampsia
0.3 grams/300 mg
(Remember no distinction between amount of proteinuria with severity of disease)
Why do we administer betamethasone for anticipated preterm delivery?
Fetal lung maturation
A 35 week patient arrives to L&D c/o headache and seeing spots in her vision. What do you anticipate for her care?
Check BPs and get labs (urine for protein, liver enzymes, platelets). NST for fetal status. Ask about pain in upper right quadrant.
To diagnose severe preeclampsia, what must the systolic blood pressure be?
≥ 160 mmHg
What does HELLP stand for?
Hemolysis
Elevated Liver Enzymes
Low Platelets
In the absence of proteinuria, what lab tests indicates a worsening renal function
(and is considered diagnostic for Pre-e with severe features)
Serum Creatinine