Pre-eclampsia *** gestational hypertension + proteinuria of greater or equal to 1+
- Report of transient headaches might occur along with episodes of irritability. Edema can be present
Gestational HTN: elevated BP at 140/90 or greater recorded on 2 different occasions, at least 4 hrs apart
Severe preeclampsia:
-BP of 160/100 or greater
-Proteinuria greater than 3+
Medication for pre-eclampsia *** MAGNESIUM SULFATE
- CNS depressant; RELAX BODY to stop contractions and pre-eclampsia seizures. May be given if mom
has protein in urine, hypertension, severe headache and unresolved edema-swollen face
Monitor for S/SX of mag toxicity:
-Absent DTR
-UO <30mL/hr
-RR <12/min
-Decreased LOC
-Cardiac Dysrhythmias
Immediately discontinue infusion
Administer antidote (Calcium Gluconate)
Preterm Labor *** Preterm labor is uterine contractions and cervical changes that occur b/w 20-36
weeks. Preterm labor can be categorized as:
-Very Preterm: less than 32 weeks of gestation
, -Moderately Preterm: 32-34 weeks of gestation
-Late preterm: 34 to 36 weeks of gestation
Shorter gestation is associated w/ increased neonate risks
preterm labor: nursing actions *** activity restriction:
- usually modified bed rest with bathroom privileges
- encourage the pt. to engage in activities that can be completed in bed or couch
- encourage the client to rest in the left lateral position to increase blood flow to the uterus
- tell the client to avoid sexual intercourse
hydration:
- dehydration can stimulate oxytocin
monitor FHR and contractions
fetal tachycardia: increased FHR greater than 160/min can indicate an infection and preterm labor
Preterm Labor Medications *** Nifedipine:
- A calcium channel blocker that is used to suppress contractions by inhibiting calcium from entering
smooth muscles
Magnesium Sulfate: CNS depressant RELAX BODY to stop contractions
Terbutaline:
- Tocolytic that inhibits contractions; not used if pt is hypertensive (not for this pt)