Magnesium Sulfate Administration Quiz
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Questions and Answers

What is a primary sign of toxicity when administering Magnesium Sulfate?

  • Elevated blood pressure
  • Slurred speech (correct)
  • Increased heart rate
  • Improved reflexes

    • What should be monitored hourly during Magnesium Sulfate infusion?

  • Calcium levels
  • Blood glucose levels
  • Electrocardiograph readings
  • Deep tendon reflexes (correct)

    • What is the recommended fluid allowance per hour during Magnesium Sulfate treatment?

  • 2ml/kg/hr
  • 50ml/hr
  • 1ml/kg/hr (correct)
  • 100ml/hr

    • If Magnesium Sulfate toxicity is suspected, what is the immediate action that should be taken?

    <p>Stop infusion and test MgSo4 levels</p> Signup and view all the answers

    What is the emergency treatment for confirmed Magnesium Sulfate toxicity?

    <p>Calcium Gluconate</p> Signup and view all the answers

    What is the loading dose of Magnesium Sulphate for preventing seizures?

    <p>4g Magnesium Sulphate in 50mls of Water for Injection over 15-20 mins</p> Signup and view all the answers

    In which situation should Magnesium Sulphate not be used?

    <p>Women who are more than 24 hours post-delivery</p> Signup and view all the answers

    What is the maintenance dose of Magnesium Sulphate?

    <p>1g/hr for 24 hours</p> Signup and view all the answers

    What is the antidote for Magnesium toxicity?

    <p>10mls of 10% Calcium Gluconate IV over 10 minutes</p> Signup and view all the answers

    How long should Magnesium Sulphate be continued for secondary prophylaxis after an eclamptic fit?

    <p>24 hours after delivery or the last seizure</p> Signup and view all the answers

    In which publication year was the guideline for managing hypertension in pregnancy released by the Royal College of Physicians in Ireland?

    <p>2016</p> Signup and view all the answers

    What is one goal of the MBRRACE-UK reports concerning maternal care?

    <p>Increasing awareness and prevention of maternal deaths</p> Signup and view all the answers

    Which of the following is a characteristic of gestational hypertension?

    <p>New diagnosis after 20 weeks of gestation</p> Signup and view all the answers

    What is one of the signs of severe pre-eclampsia?

    <p>Sudden swelling of the face, hands, or feet</p> Signup and view all the answers

    Which of the following maternal complications is associated with severe hypertension?

    <p>Intracranial haemorrhage</p> Signup and view all the answers

    What blood pressure level is considered an emergency for a pregnant woman?

    <p>≥ 160/110 mmHg</p> Signup and view all the answers

    Which symptom is NOT commonly associated with pre-eclampsia?

    <p>Increased appetite</p> Signup and view all the answers

    What is a potential fetal complication due to pre-eclampsia?

    <p>Placental insufficiency leading to hypoxia</p> Signup and view all the answers

    Which medication should be avoided in women with renal disease when treating severe hypertension?

    <p>Immediate-release nifedipine</p> Signup and view all the answers

    What is meant by the term HELLP syndrome?

    <p>Hemolysis, elevated liver enzymes, and low platelets</p> Signup and view all the answers

    What is the recommended action if a woman's blood pressure falls below 130/80 postnatally?

    <p>Reduce medication</p> Signup and view all the answers

    Which of the following should be included in a postnatal care plan for women with gestational hypertension?

    <p>Frequency of BP monitoring</p> Signup and view all the answers

    What should be done if a blood pressure reading exceeds 160/110?

    <p>Treat as an emergency and escalate care immediately</p> Signup and view all the answers

    Why should low molecular weight heparin not be given in thrombocytopenia?

    <p>It can lead to excessive bleeding</p> Signup and view all the answers

    Which procedure should be conducted for pregnant women experiencing new onset headaches?

    <p>Neurological examination and assessment for neck stiffness</p> Signup and view all the answers

    What is the leading cause of death from hypertensive disorders in pregnancy?

    <p>Intra-cerebral hemorrhage</p> Signup and view all the answers

    When should aspirin be commenced for at-risk women?

    <p>At 12 weeks gestation</p> Signup and view all the answers

    Which statement is accurate regarding automated BP monitoring systems in pre-eclampsia?

    <p>They may underestimate systolic BP</p> Signup and view all the answers

    What is the recommended hourly urine output that should be measured?

    <blockquote> <p>100ml/4hrs</p> </blockquote> Signup and view all the answers

    What should be avoided if an epidural is planned?

    <p>IV fluid pre-loading</p> Signup and view all the answers

    What is the recommended action if a patient exhibits seizures?

    <p>Consider alternative diagnoses</p> Signup and view all the answers

    How frequently should vital signs be recorded in a maternal critical care setting?

    <p>Every hour</p> Signup and view all the answers

    What medication should not be used for the third stage of labor?

    <p>Syntometrine</p> Signup and view all the answers

    What is the first step in the immediate management of eclampsia?

    <p>Call for help</p> Signup and view all the answers

    What should be done for a woman treated with anti-hypertensive medication during labor?

    <p>Continue anti-hypertensives until hypertension resolves</p> Signup and view all the answers

    What key observation should be monitored continuously if a patient is not delivered?

    <p>Continuous CTG</p> Signup and view all the answers

    Study Notes

    Severe Hypertension & Eclampsia

    • This presentation covers diagnosis and management of hypertensive disorders during pregnancy.
    • Objectives include recapping diagnosis and management, emergency management of severe hypertension, pre-eclampsia, and eclampsia, updates from NICE guidelines and MBRRACE-UK reports, and human factors considerations.
    • The presentation highlights a 1:10 ratio of women with high blood pressure during pregnancy and an estimated 6% of UK pregnancies affected by pre-eclampsia.
    • Case studies highlight the importance of baseline antenatal care, appropriate escalation, and midwife support.
    • Maternal mortality rate is low (0.3/100,000) but higher than in 2012.
    • Causes of maternal death, including intracranial hemorrhage, eclampsia/cerebral edema, pulmonary edema, hepatic rupture, etc., are detailed in tables and charts.

    Recommendations

    • Importance of baseline antenatal care; routine blood pressure checks, especially regarding proteinuria.
    • Appropriate escalation of care with IWEWS charts to be used.
    • Midwives should seek senior support with patient concerns about care.
    • Use specific communication regarding blood pressure measurement.

    Definitions

    • Essential/Chronic Hypertension: Hypertension diagnosed before or less than 20/40 weeks of pregnancy.
    • Gestational Hypertension: New diagnosis of hypertension after 20/40 weeks of pregnancy.
    • Pre-eclampsia: New hypertension >20/40 weeks of pregnancy plus significant proteinuria (urinalysis ≥1+ protein or protein creatinine ratio ≥30 mg/mmol).
    • Severe pre-eclampsia: Pre-eclampsia with severe hypertension (blood pressure ≥160/110 mmHg) and/or symptoms or biochemical or haematological impairment.
    • Eclampsia: Convulsive condition associated with pre-eclampsia.

    Signs and Symptoms

    • Pre-eclampsia signs include: frontal headache, visual disturbances, vomiting, epigastric pain, swelling of the hands or face, reduced fetal movements, and abdominal pain with/without vaginal bleeding.
    • Associated complications for pre-eclampsia include: intracranial hemorrhage, placental abruption, disseminated intravascular coagulation (DIC), eclampsia, HELLP syndrome (hemolysis, elevated liver enzymes, low platelets), renal failure, pulmonary edema, and acute respiratory arrest.

    Intracranial Hemorrhage

    • Still rare in pregnancy (15:1,000,000 pregnancies).
    • However, high blood pressure (≥160/110 mmHg) is considered an emergency in pregnant/postnatal women.

    Fetal Complications

    • Fetal complications include intrauterine growth restriction, oligohydramnios, hypoxia from placental insufficiency, placental abruption, and preterm birth.

    Aspirin Indications

    • One high risk factor: hypertensive disorder in previous pregnancy, chronic kidney disease, autoimmune diseases, type 1 or type 2 diabetes, or chronic hypertension.
    • Two or more moderate risk factors: primiparity, age 40 or older, pregnancy interval >10 years, BMI of 35 or more at booking visit, family history of pre-eclampsia, or multi-fetal pregnancies.

    Severe Hypertension Management

    • Admit and treat until blood pressure is stabilized.
    • Follow NICE guidance or severe hypertension algorithms.
    • Aim for blood pressure of 135/85 mmHg or less on treatment.
    • Monitor blood pressure every 15-30 minutes until <160/110 mmHg.
    • Daily urine dipstick for protein, while in the hospital setting.
    • Weekly FBC, U&E, and LFT at diagnosis and then every 2 weeks.
    • CTG (cardiotocography) at diagnosis and then every 2 weeks.
    • PIGF-based testing one time if pre-eclampsia is suspected.

    Severe Hypertension - Urgent Treatment Algorithm

    • A detailed algorithm for managing severe hypertension, including various treatment options, routes of administration, and guidelines to follow during various situations.

    Severe Pre-eclampsia Checklist and Management

    • A checklist covering preparation, assessment, stabilization, monitoring, and planning for patients with severe pre-eclampsia.
    • Detailed guidelines on steps to take for managing severe preeclampsia, including treatment algorithm and interventions.
    • Include steps for ongoing monitoring, potentially involving critical care/ITU if required.

    Eclampsia Emergency Box

    • Essential equipment and medications.

    Magnesium Sulfate

    • Administration and management of Magnesium Sulfate for primary and secondary prophylaxis and seizures
    • Safety monitoring should be conducted throughout treatment.

    Postnatal Care

    • Continued antihypertensives if previously administered.
    • Postnatal check-ins, similar to the frequency of antenatal follow-up.
    • Reducing medication if blood pressure falls below 130/80 mmHg.
    • All women should have a postnatal care plan including who will provide the follow-up, frequency of blood pressure monitoring, thresholds for reducing or stopping treatment, indicating referral to primary care, and self-monitoring symptoms.

    Case Summaries

    • Case histories from MBRRACE-UK reports highlight crucial recommendations like providing additional postnatal checks and continuing antihypertensive medications until hypertension is resolved, especially following treatment during pregnancy or labor.

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    Related Documents

    PROMPT Annual Update - Severe Hypertension & Eclampsia PDF

    Description

    Test your knowledge on the administration and monitoring of Magnesium Sulfate, including toxicity signs and emergency procedures. This quiz covers essential dosages, fluid allowances, and precautions. Perfect for healthcare professionals looking to refresh their understanding of Magnesium Sulfate use.

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