Vital Signs
This order should be specified by the managing physician in relation to blood pressure
What are Blood Pressure Parameters
You take 2 bp 15 min apart and both are above 160/110. What is your next plan of action?
Notify the physician
The first line drug to treat severe range blood pressures
what is labetalol
what 3 common symptoms should the nurse assess for in a PT. with high blood pressures?
what is visual changes/blurred vision, headaches, epigastric pain/RUQ pain
What are the four major diagnosis associated with hypertension in pregnancy
what is Pre-E, Eclampsia, HELLP, GHTN
Winnie Palmers standard Blood pressure parameters
what is < 160/110
PT. is currently in the middle of the hypertension protocol. You have already administered 80mg of IV labetalol and you PT has 2 more severe range BP 15min apart. What is your next action? what are your recommendations?
Call the physician to see if they would like to go to continue to the hydralazine protocol.
If the PT does not have IV access what is the drug of choice to treat severe range blood pressures
Procardia
Your pre-e PT. has +2 pitting edema in their legs. What device is recommended to prevent DVT
What are SCD's
Your patient has a plt level of 70, AST 328, ALT 481 what condition do you think this pre-eclamptic pt has developed
What is HELLP
The time between retaking a severe range blood pressure
what is 15min
The physician wants you to start your PREGNANT pre-eclamptic PT on Mag and treat severe range BP with 40 labetalol. What else do you need to ensure is being monitored at this time?
The baby needs to be on the monitor
If the PT has IV access and has went through the entire Labetalol protocol what is the next drug of choice for continued severe blood pressures
What is Hydralazine
What are two treatments for a PT c/o a 6/10 HA
What is tylenol/ fiorocet, HA cocktail (benadryl, compazine, phenergan)
Name a common diagnostic test collected over 24hrs for pre-eclampsia
What is a 24hr Urine
You take two blood pressures 15min apart and both are greater than 160/110. The physician orders 20mg IV Labetalol. When should the next BP be taken?
What is 15min after administration of the medication.
Your pregnant PT has two severe range BP's. you call 2nd and 4th yr residents who are managing her for additional orders. Both physicians are in a stat in the OR. what is your next plan of action?
Call the third yr. and explain the situation in SBAR format.
First Line drug for eclampsia
What is Magnesium
Your pt starts to c/o unrelenting RUQ pain. What labs do you anticipate the physician to order?
CMP/BMP. Specifically AST, ALT, and platelets
Your PT's pr/cr ratio is 0.5, has 2 blood pressures 15min apart greater than 160/110, and complains of a HA for the past 2 days. What is this PT diagnosed with? (the answer is not just pre-e)
Pre-E with severe features
After one dose of labetalol your PT. bp is no longer severe range (160/110). If all bp remain under 160/110 what is the frequency of Vital signs for the next 4hrs
what is q15min for 1hr, q 30min for 1hr, q hr for 2hrs
Your preeclamptic PT states she is starting to see spots. You haven't taken a BP in 3 hrs. After taking the BP you note that it is 175/98. When should you notify the physician
Now because the PT has an acute change. Retake the BP in 15min but notify the physician of these findings ASAP as they may want to order LABS or start PT on Magnesium.
What is the cure for Pre-eclampsia, eclampsia, HELLP
Delivery
Your pregnant PT. is c/o 8/10 RUQ pain without palpation, and a HA. She is already on Magnesium. She states it is not getting better. The MD orders an Abdominal US. Labs reveal severe HELLP syndrome. What is your next anticipated action?
Prepare PT. for delivery
What are 2 things physicians are specifically looking at in a 24hr urine ?
what is a total protein and protein creatinine ratio.