Recognition
BP that indicates gestational hypertension.
What is 140/90?
Sitting on the side of the bed with feet on the floor, legs uncrossed, after resting, and using an appropriate size BP cuff.
What is the ideal approach for obtaining the BP?
BP is elevated before 20 weeks of pregnancy.
What is chronic HTN?
The typical loading dose for mag sulfate.
What is 4gm?
Every 15 minutes x2, every 30 minutes until one hour, every hour x8, every 2 hours x 12, then every four hours.
What is the frequency of obtaining and monitoring pulse, respirations, blood pressure, O2 sat, level of consciousness (LOC), peripheral edema, DTR, FHR, and contractions? (See policy for more specifics.)
Lab that is diagnostic for preeclampsia.
What is the protein/creatinine ratio?
Precautions that should be used with a hypertensive diagnosis.
What are seizure precautions?
Hemolysis, elevated liver enzymes, and low platelets.
What is HELLP syndrome?
Two nurses are required for the process.
How many nurses are required for verification of mag sulfate?
The frequency for assessing urinary output.
What is every hour?
BP that indicates severe hypertension.
What is 160/110?
BP values reported to the provider.
What is 140/90 and/or 160/110?
Patient with preeclampsia that is having seizures.
What is eclampsia?
Two items that must be at the bedside when infusing magnesium sulfate.
What are calcium gluconate and a reflex hammer?
Respirations are less than 12 per minute b. Shortness of breath c. Chest pain d. Blood pressure is less than 90/60 or greater than 160/110. e. Absence of patellar reflexes f. Change in lung sounds suggestive of pulmonary edema g. New or worsening peripheral edema h. Change in level of consciousness i. Urinary output less than 30ml/hour j. Any change in patient condition
What are symptoms to notify the provider of?
Headache, blurred vision, seeing spots, and epigastric pain.
What are symptoms of elevated BP?
Symptoms that all patients should be taught before discharge to call their provider.
What are headache, blurred vision, seeing spots, and epigastric pain?
Medication that may be given to prevent seizures.
What is magnesium sulfate?
The antidote for magnesium sulfate.
What is calcium gluconate?
Magnesium level > or = to 7.
At what value does the physician have to be notified of the magnesium level?
Protein/creatinine value that indicates preeclampsia.
What is 0.3 or higher?
Oxygen, oral airway, suction, and padded side rails.
What are seizure precautions?
Additional medications that are sometimes used to manage severe hypertension.
What are labetalol and hydralzine?
Vital signs, O2 sat, deep tendon reflexes, presence of clonus, level of consciousness, edema amount and location, breath sounds, FHR, and contractions
What are the components of the baseline assessment before starting mag sulfate?
Cardiac arrhythmias, including arrest • Central nervous system depression • Decreased or absent deep tendon reflexes • Decreased renal function • Muscle flaccidity • Respiratory depression
What are symptoms of magnesium toxicity?