Question

outline in a stepwise manner the pharmacological management of severe preeclampsia

Answer 1

Preeclampsia is a potentially serious complication of pregnancy with increasing significance worldwide.

Primary Goals:
– Prevent convulsions through the use of Magnesium Sulfate
– Ensure adequate kidney function
– Monitor fetal status- assure moderate variability preliminary to beginning Magnesium Sulfate
– Stabilize the woman so that delivery can be achieved.

# Severe Preeclampsia:-

 The fetal outcome is poor, often as a result of growth restriction and/or asphyxia at birth.
 Incidence of serious complications in the mother is high
 Signs to watch for:
– Abruptio placentae
– HELLP syndrome
– Eclampsia
– DIC
– Acute Renal Failure

# management of severe preeclampsia:-

Nursing management includes assessment of maternal response to antihypertensive therapy.

 BP rises to 160/110 mmHg or higher on two different occasions 4 hours apart.

The goal is to stabilize blood pressure at 140-150/90-100 mmHg .
 Proteinuria is 5 g or higher in a 24 hours urine specimen.
 Urine output decreases to less than 500ml in 24 hours. The kidneys can go into failure with little output. This is a serious situation that can lead to permanent injury.

Nursing management includes assessment for magnesium toxicity.

Fluid replacement should be careful, even with oliguria, as preeclampsia predisposes women to fluid imbalance.

Note: clinical signs of preeclampsia can appear suddenly. Never underestimate the importance of even mild BP elevations complicated in pregnancy.