BP Assessment / Pressures on!
If the BP cuff is too large, the reading may be falsely ___.,
What is low?
In patients with preeclampsia, you should limit total IV fluid to a maximum of this amount. This helps to balance reduction of pulmonary edema without an increase in acute kidney injury. You can also consider strict ins and outs for patients with preeclampsia with severe features.
What is 80 ml/hour?
When to check next if a patient's SBP is between 140 to 159 mmHG OR the DBP is 90-109 mmHg?
Hypertensive disorders of pregnancy are an indication for this
What is intrapartum electronic fetal monitoring?
Blood pressure usually peaks around this time, when fluid shifts bring extracellular fluid back into vasculature.
What is 3-7 days?
What is allow patient to rest for 5-10 minutes, keep still, not to talk, and minimize background noise?
Hold antihypertensive medication if a patient's BP is this.
What is less than 110/60?
If BP is confimed at SBP greater than or equal to 160 mmHg OR DBP is greater than or equal to 110 mmHg, this is when you should you check next.
What is: REPEAT BP in 15 minutes or less?
Follow up:
1) How often would you reassess BP if it is only greater than or equal to 160/110 x 1?
Preeclampsia is correlated with an increased risk for this
What is Postpartum Hemorrhage?
This medication is contraindicated for PPH management in patients with preeclampsia with severe features. What are some other medications that should be prioritized instead?
What is ergot? Other alternatives include oxytocin, carbetocin, carbroprost.
If there are concerns with the automatic machine accuracy, you should do this.
What is repeat the BP with a manual manometer and stethoscope?
How to prevent or detect pulmonary edema
What is monitor and document fluid balance?
If BP is greater than or equal to 160/110 x 2, these are your next steps and what you can anticipate.
What are: notify the MRP and seek orders for anti-hypertensive medication administration, prepare for urgent adminsisration of antihypertensive medication, continue to assess for severe features of preeclampsia, anticipate likely need to expedite inititiation of magnesium sulfate, consider urgent need for admission/transfer to TACC, document?
This is how often to assess BP, HR, RR, SpO2 when a patient is intrapartum
What is Q1H?
There are risks of fetal growth restriction, small for gestational age (SGA) and late preterm birth. What might you anticipate?
What are: increased monitoring and blood glucose assessments? (risk of hypoglycemia and may experience bradycardia)
Newborns exposed to antihypertensives via human milk should also be monitored for drowsiness, lethargy, pallor, cold peripheries, or poor feeding
If SBP greater than or equal to 150 mmHG or DBP greater than or equal to 90 mmHg x 2, you should include this in your assessment
What are: assess for severe features of preeclampsia, auscultate all lung fields for advenititious sounds, baseline evaluation of deep tendon reflexes
(page 27 of protocol)
What is:
Q15 mins x 4, then
Q30 mins x 2, then
Q1h x 2, then
every 4 hours x 12-24 hours, then
q shift
Antihypertensive treatment with medications must be initated as soon as possible. Lowering the BP to less than 160/110 mmHg reduces the risks of this (#1) . and (#2) These are the medications that are used at our site.
1) What is severe maternal morbidity including hemmorrhagic and ischemic stroke, myocardial infarction, congestive heart failure and renal injury and failure?
2) What are nifedipine (oral) swallowed whole, not bitten or punctured, and labetalolol (continuous iv infusion/iv direct) or hydralazine (iv direct)
What is 6 hours?
For patients with reoccurence of severe hypertension in pregnancy, the addition of this medication may be beneficial in lowering BP and in reducing the need for other antihypertensive medications postpartum.
What is oral furosemide?