Stopper Secrets
What is the first-line medication for an eclamptic seizure?
What is Magnesium sulfate, 4-6 grams loading dose
What is the protein/creatinine ratio threshold that confirms preeclampsia?
What is ≥ 0.3
When should the first postpartum follow-up visit occur for patients with preeclampsia?
Within 3-7 days
What information should be communicated during a hypertensive emergency?
What is SBAR, such as patient’s BP, symptoms, medications administered, and next steps/recommendation
What is the antidote to magnesium sulfate toxicity and how is it administered?
What is Calcium gluconate 1g over 3 minutes IV push (or 2-5 minutes IV push)
If a seizure recurs after magnesium sulfate, what should be administered?
What is an additional 2-4 grams of magnesium sulfate over 5 minutes
Name the severe features of preeclampsia.
Severe headache, visual disturbances, or RUQ pain
What mental health condition should be assessed postpartum for women with HDP?
What is Anxiety or PTSD
Why is implicit bias training important for healthcare staff?
To ensure timely and respectful care for all patients
If a patient's heart rate is <60 bpm, and has asthma which antihypertensive medication is preferred?
What is hydralazine or Nifedipine
What are signs of magnesium toxicity to monitor during treatment?
What is loss of deep tendon reflexes, respiratory depression, or cardiac arrhythmias
At what gestational age should delivery be planned for preeclampsia without severe features?
What is 37 weeks
Why is a home blood pressure cuff important after discharge?
What is to monitor for severe hypertension and prevent delays in care
What is the protocol for BP monitoring after a severe-range reading?
Measure BP every 15 minutes for at least one hour
Over how many minutes should IV hydralazine or labetalol be administered?
Administer hydralazine or labetalol over 2 minutes to prevent abrupt hemodynamic changes
What position is recommended during a seizure to prevent aspiration?
Left lateral decubitus
How quickly should antihypertensives be administered after the confirmed 15 confirmation of initial severe blood pressure
Antihypertensive therapy should ideally begin within 30 minutes, but no later than 60 minutes, after the first severe-range BP reading
What is a long-term health risk for women who had preeclampsia?
What is cardiovascular disease
Why is initiating antihypertensive treatment prioritized over magnesium sulfate in severe hypertension?
To prevent stroke, the leading cause of maternal death in hypertensive emergencies
What are the maximum doses of IV labetalol, hydralazine, and oral nifedipine in managing acute-onset severe hypertension.
Double Jeopardy!!!
How should blood pressure be measured 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.
For a patient experiencing recurrent seizures after a magnesium sulfate loading dose and a secondary bolus, list two next-line medications with their dosing guidelines.
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
What is the medical term for "seeing spots" or visual disturbances commonly associated with preeclampsia, and what is the underlying mechanism?
Medical Term: Scotomata (singular: scotoma).
Mechanism: 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
What education should be emphasized to postpartum women with HDP?
Recognizing signs like severe headache, vision changes, or BP ≥ 160/110
What is the purpose of team debriefings after a hypertensive emergency?
To refine communication and improve future outcomes
In a patient with HELLP syndrome, what are the specific threshold values for platelet count, and why is it critical to monitor closely before any surgical intervention?
Double Jeopardy Question: What does HELLP stand for
Threshold Values: Platelet count < 100,000/mm³ for diagnosis, and surgical interventions may require platelet levels > 50,000/mm³ to minimize bleeding risk.
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
Hemolysis, Elevated Liver enzymes, Low Platelet count. Lab findings include increased LDH (indicative of hemolysis) and AST/ALT elevation