MMPN Assessment Quiz

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Questions and Answers

What is one of the first actions to be taken for a patient treated for pregnancy-induced hypertension (PIH)?

Start intravenous fluids immediately

Place the patient in a sitting position

Administer oxygen via nasal cannula

Place the patient in the recovery position on her left side (correct)

Which blood pressure reading is indicative of pre-eclampsia in a pregnant female during her second half of pregnancy?

140/90 mmHg (correct)

150/95 mmHg

120/80 mmHg

130/85 mmHg

What is a common symptom of pre-eclampsia?

Increased appetite

Nausea and vomiting (correct)

Excessive sweating

Fatigue during the day

What should be avoided when transporting a pre-eclamptic patient?

Transporting in bright light Signup and view all the answers

Which medication is recommended for treating severe hypertension in a pre-eclamptic patient?

Magnesium sulfate Signup and view all the answers

What is the initial dosage of magnesium sulfate given for treating pre-eclampsia?

4 grams in 50 mL Signup and view all the answers

If the blood pressure remains elevated after administering magnesium sulfate, what medication should be considered next?

Nicardipine (Cardene) Signup and view all the answers

When should a pregnant patient be treated for hypertension?

If the diastolic BP is equal to or greater than 90 mmHg on two readings at least 5 minutes apart Signup and view all the answers

What action should not be taken during the external exam of a pre-eclamptic patient?

Perform a manual pelvic exam Signup and view all the answers

What should be the goal blood pressure when administering nicardipine for a pre-eclamptic patient?

Systolic around 140 mmHg and diastolic 90 mmHg Signup and view all the answers

What should be established immediately upon suspected maternal use of narcotics within the last four hours?

Vascular access Signup and view all the answers

Which condition is NOT a common cause of vaginal bleeding during the first trimester?

Placenta previa Signup and view all the answers

When a pregnant patient in her third trimester becomes hypotensive, which position should be utilized to alleviate pressure on the Inferior Vena Cava?

Left lateral position Signup and view all the answers

What is the first step in the treatment for hypotension in a pregnant patient during their first trimester?

Establish vascular access Signup and view all the answers

Which condition does NOT necessitate consideration when examining a woman of childbearing age who presents with lower abdominal pain?

Fibroids Signup and view all the answers

What is the blood pressure threshold for suspecting hypertension in pregnant females during the second half of pregnancy?

140/90 mm Hg Signup and view all the answers

In case of uterine rupture during the third trimester, which of the following is a critical action to take?

Establish vascular access Signup and view all the answers

What should be done if a pregnant patient presents with a systolic blood pressure lower than 90 mmHg?

Administer normal saline, 500 mL IV Signup and view all the answers

Study Notes

Meconium, Multiple Births, and Prematurity

Assessment of meconium: check for foul odor or pea soup-like discharge when water breaks; note thickness of meconium.
Inquire if the mother suspects multiple births.
Verify if delivery is occurring before the Estimated Delivery Date.

Narcotics and Ectopic Pregnancy

Investigate any maternal use of narcotics within the last four hours; establish vascular access and transport to an obstetrics-capable facility.
Ectopic pregnancy risk in women of childbearing age presenting with lower abdominal pain and/or vaginal bleeding.

Hemorrhage During First Trimester

Common causes of first-trimester bleeding: threatened miscarriage and ectopic pregnancy.
Establish vascular access; administer normal saline (500 mL IV) for hypotensive patients (systolic BP < 90 mmHg).

Hemorrhage During Second and Third Trimester

Massive vaginal bleeding causes in late pregnancy: abruptio placenta, placenta previa, uterine rupture.
In case of hypotension in a pregnant patient with a palpable uterus, critical positioning is required to alleviate pressure on the inferior vena cava.
Position the patient on the left side and raise the right side if necessary; treat for hypovolemic shock.

Hypertension in Pregnancy

Hypertension suspected in females during second half of pregnancy if BP ≥ 140/90 mm Hg or rises 30 mm Hg systolic/15 mm Hg diastolic above normal.
Asymptomatic treatment includes left side recovery position, vascular access establishment, and monitoring during transport.

Pre-Eclampsia

Pre-eclampsia presents with hypertension and may occur up to six weeks postpartum.
Signs include generalized edema, persistent headaches, upper abdominal pain, visual disturbances, nausea, irritability, and difficulty breathing.
Treat symptomatic patients with BP ≥ 140/90 mm Hg and headache or visual changes; administer magnesium sulfate (4 grams in 50 mL D5W/NS) slowly IV/IO.

Management of Severe Hypertension

For severe hypertension (systolic ≥ 160 mmHg or diastolic ≥ 110 mmHg), administer nicardipine (Cardene) if available, to achieve target BP of approximately 140/90 mmHg.
If nicardipine is unavailable, transport to a facility while monitoring BP; increase nicardipine infusion rate if necessary after reassessment.
Use discretion with transport environment to avoid triggering seizures in pre-eclamptic patients.

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Description

This quiz evaluates key considerations in maternal-fetal health, focusing on meconium characteristics, multiple births, delivery timing, and narcotic use. Answer these questions to assess the readiness for potential complications during delivery. Perfect for healthcare professionals involved in obstetric care.