Questions and Answers
What is one of the first actions to be taken for a patient treated for pregnancy-induced hypertension (PIH)?
Which blood pressure reading is indicative of pre-eclampsia in a pregnant female during her second half of pregnancy?
What is a common symptom of pre-eclampsia?
What should be avoided when transporting a pre-eclamptic patient?
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Which medication is recommended for treating severe hypertension in a pre-eclamptic patient?
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What is the initial dosage of magnesium sulfate given for treating pre-eclampsia?
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If the blood pressure remains elevated after administering magnesium sulfate, what medication should be considered next?
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When should a pregnant patient be treated for hypertension?
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What action should not be taken during the external exam of a pre-eclamptic patient?
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What should be the goal blood pressure when administering nicardipine for a pre-eclamptic patient?
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What should be established immediately upon suspected maternal use of narcotics within the last four hours?
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Which condition is NOT a common cause of vaginal bleeding during the first trimester?
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When a pregnant patient in her third trimester becomes hypotensive, which position should be utilized to alleviate pressure on the Inferior Vena Cava?
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What is the first step in the treatment for hypotension in a pregnant patient during their first trimester?
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Which condition does NOT necessitate consideration when examining a woman of childbearing age who presents with lower abdominal pain?
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What is the blood pressure threshold for suspecting hypertension in pregnant females during the second half of pregnancy?
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In case of uterine rupture during the third trimester, which of the following is a critical action to take?
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What should be done if a pregnant patient presents with a systolic blood pressure lower than 90 mmHg?
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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.
