What are the management of severe eclampsia?
Medications to treat severe preeclampsia usually include: Antihypertensive drugs to lower blood pressure. Anticonvulsant medication, such as magnesium sulfate, to prevent seizures. Corticosteroids to promote development of your baby’s lungs before delivery.
Which is the drug of choice in management of eclampsia?
Magnesium sulphate: the drug of choice in eclampsia.
Which is the immediate nursing action during eclampsia?
Nursing Management
Monitor blood pressure. Assess fetal heart rate. Send blood and urine for testing. Administer prescribed medications.
How do you treat eclamptic seizures?
Magnesium sulfate should be given to control convulsions and is the first-line treatment for eclamptic seizures. A loading dose of 4 to 6 grams should be given intravenously over 15 to 20 minutes. A maintenance dose of 2 g per hour should subsequently be administered.
How is mgso4 given in eclampsia?
It is usually given by either the intramuscular or intravenous routes. The intramuscular regimen is most commonly a 4 g intravenous loading dose, immediately followed by 10 g intramuscularly and then by 5 g intramuscularly every 4 hours in alternating buttocks.
What is the first line treatment for preeclampsia?
Hydralazine and labetalol are the two “first line” agents used for hypertension in preeclampsia. Hydralazine is an arteriolar dilator that reduces blood pressure but may cause tachycardia.
How do you manage emergency hypertension during pregnancy?
Management. Regardless of the hypertensive disorder of pregnancy, BP requires urgent treatment in a monitored setting when severe (>160/110 mm Hg); acceptable agents for this include oral nifedipine or intravenous labetalol or hydralazine. Oral labetalol may be used if these treatments are unavailable.
What are the four stages of eclamptic fits?
The four phases of seizure are:
- Prodromal.
- Early ictal (the “aura”)
- Ictal.
- Postictal.
What are priority nursing interventions for preeclampsia?
Nursing Interventions and Rationales
- Provide frequent rest periods with bed rest.
- Instruct the client to elevate legs when sitting or lying down.
- Monitor the client’s BP and instruct monitoring of BP at home.
- Record and graph vital signs, especially BP and pulse.
What is antidote of magnesium sulphate?
Calcium gluconate: the antidote for magnesium toxicity is calcium gluconate 1 g IV over 3 minutes. Repeat doses may be necessary. Calcium chloride can also be used in lieu of calcium gluconate.
How quickly can you give IV magnesium?
As a general guideline, 8-12 g of magnesium sulfate (32-48 mmol Mg2+) can be administered in the first 24 hours followed by 4-6 g (16-24 mmol Mg2+) per day for 3 or 4 days, to replete body stores. Maximum infusion rates should not exceed 2 g/hour (8 mmol Mg2+/hour).
What medication is contraindicated in preeclampsia?
Renin-angiotensin-aldosterone system blockers—such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, renin inhibitors, and mineralocorticoid receptor antagonists—should be avoided.
How do you stop a hypertensive crisis complicated by preeclampsia?
First-line intravenous drugs include labetalol and hydralazine, but other agents may be used, including esmolol, nicardipine, nifedipine, and, as a last resort, sodium nitroprusside. Among patients with hypertensive urgency, slower blood pressure reduction can be provided with oral agents.
How do you treat hypertensive emergency?
The drugs of choice in treating patients with a hypertensive emergency and acute renal failure are clevidipine, fenoldopam, and nicardipine (5). The initial infusion rate of intravenous fenoldopam is 0.1 to 0.3 mcg/kg/min. The maximum infusion rate is 1.6 mcg/kg/min.
What is the most common complication of eclampsia?
The incidence of severe preeclampsia/eclampsia was 1.3% at Mpilo Central Hospital. The most common major complication was HELLP syndrome (9.1%).
What are the warning signs of eclampsia?
As pre-eclampsia progresses, it may cause:
- severe headaches.
- vision problems, such as blurring or seeing flashing lights.
- pain just below the ribs.
- vomiting.
- sudden swelling of the feet, ankles, face and hands.
How is preeclampsia clinically managed?
The current clinical management of PE is hydralazine with labetalol and magnesium sulfate to slow disease progression and prevent maternal seizure, and hopefully prolong the pregnancy.
Why is magnesium sulfate given for preeclampsia?
Magnesium sulfate therapy is used to prevent seizures in women with preeclampsia. It can also help prolong a pregnancy for up to two days. This allows drugs that speed up your baby’s lung development to be administered.
What is the protocol for magnesium sulphate?
Magnesium sulphate is recommended as the first-line medication for prophylaxis and treatment of eclampsia. The loading dose is 4 g IV over 20 to 30 min, followed by a maintenance dose of 1 g/h by continuous infusion for 24 h or until 24 h after delivery, whichever is later.
Does magnesium sulphate lower BP?
Conclusion: Maternal magnesium sulfate reduces blood pressure and increases neonatal size compared to L-NAME without magnesium. These findings support a beneficial effect of magnesium in preeclampsia.
What happens if you give magnesium IV too fast?
In patients with a pulse, it’s recommended to give 1-2 grams of magnesium in adults (or 25-50 mg/kg/dose with a maximum of 2 grams) over 15 minutes in pediatric patients. This is because overly rapid administration can cause hypotension and even asystole- risks we don’t want to take in an already tenuous situation.
Can you push IV magnesium?
To initiate therapy, 4 g of Magnesium Sulfate in Water for Injection may be administered intravenously. The rate of I.V. infusion should generally not exceed 150 mg/minute, or 3.75 mL of a 4% concentration (or its equivalent) per minute, except in severe eclampsia with seizures.
Why diuretics are avoided in pre eclampsia?
Diuretic drugs cause people to excrete more urine and relax the blood vessels thus reducing the blood pressure. Because of these effects, it has been suggested that these drugs might prevent women from getting pre‐eclampsia.
What is the first thing to do in hypertensive crisis?
The first-line treatment for hypertensive crisis will typically be intravenous antihypertensive medications to lower the person’s blood pressure. Healthcare providers usually aim to reduce blood pressure by no more than 25% in the first hour, as rapid decreases in blood pressure can cause other problems.
What is the standard treatment for hypertensive crisis?
The drugs of choice in treating patients with a hypertensive crisis and eclampsia or pre-eclampsia are hydralazine, labetalol, and nicardipine (5,6). Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, direct renin inhibitors, and sodium nitroprusside are contraindicated in treating these patients.