Adult Pre-eclampsia/Eclampsia

Question 1

Adult Pre-eclampsia/Eclampsia - Mild Symptoms

Answer 1

hypertension
edema
proteinuria

Question 2

Adult Pre-eclampsia/Eclampsia - Moderate/Severe Symptoms

Answer 2

Blood pressure of 160/100 mmHg or higher
Generalized edema
Shortness of breath / pulmonary edema
Severe headache
Visual disturbances
Blindness
Confusion
Upper right quadrant abdominal or epigastric pain
Nausea
Seizures

Question 3

Adult Pre-eclampsia/Eclampsia - Most commonly seen during what period of pregnancy?

Answer 3

last 10 weeks of gestation (30-40 wks)
during labour
first 48 hours post-partum

Question 4

Adult Pre-eclampsia/Eclampsia - Eclampsia presentation

Answer 4

Grand mal seizure activity

Question 5

Adult Pre-eclampsia/Eclampsia - Third Trimester and seizing actions?

Answer 5

Magnesium Sulfate 4 g IV/IO in 50 ml over 20 min,

Consider concurrent Midazolam 5 mg IV or 10 mg IM

Question 6

Adult Pre-eclampsia/Eclampsia - Seizures ongoing after Magnesium loading dose and initial Midazolam actions?

Answer 6

Magnesium Sulfate 2 g IV/IO in 50 ml over 20 min,

Concurrent midazolam to max of 20 mg

Question 7

Adult Pre-eclampsia/Eclampsia - Moderate or Severe symptoms without seizure activity action?

Answer 7

Mandatory OLMC

Question 8

Adult Pre-eclampsia/Eclampsia - Magnesium Sulfate Indication?

Answer 8

Moderate / severe eclampsia symptoms

Question 9

Adult Pre-eclampsia/Eclampsia - Magnesium Sulfate dose?

Answer 9

Loading dose: 4 g IV/IO in 50 mL NS over 20 min

Maintenance dose: 2 g IV/IO in 250 mL NS or D5W over 60 min

Recurrent or ongoing seizures: Mandatory OLMC - 2 g IV/IO diluted in 50 mL NS over 20 min

Question 10

Adult Pre-eclampsia/Eclampsia - Magnesium Sulfate Contraindiations?

Answer 10

Any degree of heart block

Renal failure

Question 11

Adult Pre-eclampsia/Eclampsia - Magnesium Sulfate Precautions?

Answer 11

Monitor for respiratory depression

Rapid administration of magnesium sulfate could lead to respiratory and/or cardiac arrest

Question 12

Adult Pre-eclampsia/Eclampsia - Midazolam Indication?

Answer 12

Recurrent or ongoing seizures or inability to establish vascular access

Question 13

Adult Pre-eclampsia/Eclampsia - Midazolam Dose?

Answer 13

Administered concurrently with magnesium sulfate:
5 mg SIVP/IO q 5 minutes prn total max 20 mg Or
10 mg IM - no repeat

Question 14

Adult Pre-eclampsia/Eclampsia - Midazolam Contraindiations?

Answer 14

Hypersensitivity to benzodiazepines
Myasthenia gravis
Systolic BP less than 100 mmHg

Question 15

Adult Pre-eclampsia/Eclampsia - Midazolam Precautions?

Answer 15

May cause respiratory depression and hypotension; monitor vital signs closely post administration