OB

Question 1

Pregnancy and AMS

Answer 1

Pregnancy: eclampsia, abruption/AFE
Neuro: hemorrhage, infarction, tumor, epilepsy, encephalitis, meningitis
Metabolic: hyponatremia, hypoglycemia
Other: medication, trauma

Question 2

Preeclampsia & Severe Preeclampsia Diagnostic Criteria

Answer 2

1. SBP >140 or DBP >90 (x2, 4 hrs apart)
2. Proteinuria (24 hr >300 or protein/Cr ratio 0.3)
3. > 20 weeks gestation

Severe +1 of:

1. SBP >160 or DBP >110 (x2, 4 hrs apart)
2. Renal insufficiency (Cr >1.1)
3. CNS disturbance (HA, vision change)
4. Pulmonary edema
5. Liver dysfxn
6. Epigastric/RUQ pain
7. Thrombocytopenia

Question 3

Suspected Magnesium Toxicity: To Do

Answer 3

1. Order Mg level
2. Check DTRs
3. Discontinue infusion
4. Prepared treat seizure
5. Diuretic (increases renal excretion of Mg)
6. Calcium gluconate (antagonize neuro and cardiac effects of Mg)

Question 4

Magnesium Toxicity Levels

Answer 4

Therapeutic: 4-8 mEq/L

5-10: EKG changes

10: muscle weakness, loss DTRs
15: SA/Av node block, respiratory paralysis
20: cardiac arrest