Preeclampsia Assessment
- After 20 Weeks of Pregnancy
- Hypertension > 140/90
- Proteinuria or End-Organ Dysfunction
- Hypertension > 160/110
- Progressive Renal Insufficiency
- Vision Changes
- HELLP Syndrome
- Pulmonary Edema
Preeclampsia Interventions
- Side Lying Position and Bedrest
- Antihypertensives
- Magnesium Sulfate
- Labor Induction
Eclampsia
- Increased Central Nervous System Irritability
- Hyperreflexia
- Positive Ankle Clonus
- Headaches
- Visual Disturbances
- Epigastric or RUQ Pain
- Seizures
- Coma
- Don't Leave Bedside
- Magnesium Sulfate
Severe Preeclampsia
- Vasospasm and Decreased Organ Perfusion
- Intravascular Coagulation
- Increased Permeability and Capillary Leakage
- Hypertension
- Proteinuria or End-Organ Dysfunction
- Hepatic Dysfunction and Hemolysis
- Elevated Liver Enzymes
- Low Platelet Counts
Chorioamnionitis
- Fever
- Maternal or fetal tachycardia
- Leukocytosis
- Foul Odor to Amniotic Fluid
- Treatment: Antibiotics
- Monitor uterine tenderness, contractions and fetal activity
- Monitor maternal vital signs & FHR
Pregnant Cardiac Patient Assessment
- Cardiac Decompensation
- Frequent Cough
- Dyspnea
- Palpitations
- Excessive Fatigue
- Pulse > 100 bpm
- Crackles
Pregnant Cardiac Patient Interventions
- Monitor for Cardiac Decompensation
- Stool Softener
- Calcium Channel Blockers
- ECG Monitor
- Open Glottis Pushing
- Pulmonary Artery Catheter
- No Beta-Adrenergic Medications
- Penicillin Prophylaxis
- Stress on Heart
Pregnant Diabetic Patient Interventions
- Increase Insulin then Decrease
- Metformin
- Nutrition
- Exercise
- Increase Insulin
- More Likely to Develop Hypoglycemia than Hyperglycemia
- Double or Quadruple Insulin
- Early Delivery
- Drastically Decrease Insulin
- Monitor Neonate for Hypoglycemia