Stopper Secrets
The first-line medication administered to treat an eclamptic seizure
What is Magnesium sulfate, 4-6 grams loading dose
The protein/creatinine ratio threshold that confirms preeclampsia
What is ≥ 0.3
The timeframe the first postpartum follow-up visit occurs for patients with preeclampsia
What is within 1-3 days after discharge
Critical information to share during a hypertensive emergency, using SBAR
What is BP, symptoms, medications given, and next steps
The antidote for magnesium sulfate toxicity and administration protocol
What is Calcium gluconate 1g over 2-5 minutes IV push)
Administered if a seizure recurs after the initial dose of magnesium sulfate
What is an additional 2-4 grams of magnesium sulfate over 5 minutes
These are considered severe symptoms of preeclampsia
What is severe headache, visual disturbances, or RUQ pain
These mental health conditions are assessed postpartum for women with HDP
What is Anxiety or PTSD
Training that ensures timely and respectful care for all patients
What is implicit bias training
The preferred antihypertensive for patients with asthma and a heart rate <60 bpm
What is hydralazine or Nifedipine
Signs of magnesium toxicity that must be closely monitored during treatment
What is loss of deep tendon reflexes, respiratory depression, or cardiac arrhythmias
The protocol once threshold blood pressure has been reached
What is 10 minutes for 1 hour, every 15 minutes for 1 hour, 30 minutes for 1 hour, every hour for 4 hours
A vital tool for postpartum women to monitor BP at home after discharge
What is a home blood pressure cuff
The protocol used after obtaining a severe-range reading (assuming no anti-hypertensive medications have been administered).
What is measure BP every 15 minutes for at least one hour
The timeframe for administering IV hydralazine or labetalol to avoid abrupt hemodynamic changes
What is administer over 2 minutes
The position recommended during a seizure to prevent aspiration.
What is left lateral decubitus
The maximum time allowed to administer antihypertensives after confirmed severe-range BP
What is 60 minutes, ideally within 30 minutes
The long-term health risk for women who had preeclampsia
What is cardiovascular disease
The reason why treating severe hypertension with anti-hypertensives takes priority over magnesium sulfate
What is to prevent stroke
The daily maximum (in mg) of IV labetalol, hydralazine, and oral nifedipine in managing acute-onset severe hypertension.
Double Jeopardy!!!
The correct steps of measuring blood pressure to ensure accuracy
Maximum Doses:
Labetalol: 300 mg total (administered as incremental doses of 20 mg, 40 mg, 80 mg, etc.).
Hydralazine: 20 mg total (administered as 5-10 mg increments).
Nifedipine: 50 mg total (administered as immediate-release 10-20 mg tablets every 20-30 minutes)
Double jeopardy answer:
Use a manual or validated automated cuff in the correct size.
Position the patient seated or semi-reclined with the arm supported at heart level.
Ensure the patient rests for 5 minutes prior to measurement and avoids talking or movement during the reading.
Two next-line medications and their dosing for recurrent seizures after additional magnesium sulfate bolus.
Midazolam: 1-2 mg IV, may repeat every 5-10 minutes.
Diazepam: 5-10 mg IV, slowly administered, may repeat every 15 minutes to a maximum of 30 mg
The medical term for "seeing spots" and visual disturbances (diminished vision) commonly associated with preeclampsia.
Medical Term: Scintillation or Scotomata (singular: scotoma).
Mechanism: Scintillations are caused by cerebral vasospasm (blood vessel constriction in the brain) and hypertensive changes in the retina
Scotomata occur due to cortical or retinal ischemia caused by vasospasms or endothelial dysfunction, leading to reduced blood flow to the optic nerve or occipital cortex.
This education should be emphasized prior to discharge
What are signs and symptoms of pre-eclampsia like severe headache, vision changes, or BP ≥ 160/110
A post-crisis practice that helps improve communication and outcomes after a hypertensive emergency
What is a team briefing
Platelet count thresholds critical for HELLP syndrome and its relevance before surgery or epidural.
What is platelet count < 100,000/mm³ for diagnosis, and platelet levels > 50,000/mm³ for surgery/epidural to reduce bleeding risks
***Critical Monitoring: Low platelet levels increase the risk of hemorrhage during surgery or delivery. This is due to disseminated intravascular coagulation (DIC), a potential complication of HELLP syndrome***