SOLUTIONS REVIEW PACK
◉ signs of magnesium sulfate toxicity.
Answer: depressed DTR, decreased urine output, decreased
respiratory rate, muscle weakness, decreased LOC
◉ What do we assess when mom is on magnesium sulfate.
Answer: LOC, headache, epigastric pain, visual disturbances, DTR,
FHR and variability
◉ Antidote for magnesium sulfate.
Answer: calcium gluconate; must be at bedside
◉ Contraindications for Magnesium Sulfate.
Answer: myasthenia gravis (respiratory depression), severe renal
failure, cardiac ischemia, heart block, pulmonary edema, high mag or
low calcium level
◉ HELLP syndrome.
Answer: life-threatening pregnancy complication often associated
with preeclampsia
,◉ HELLP syndrome stands for.
Answer: hemolysis, elevated liver enzymes, and low platelets
◉ Signs of HELLP syndrome.
Answer: epigastric pain, n/v, malaise, edema, s/s of preeclampsia
◉ Management of HELLP syndrome.
Answer: Mag sulfate, transfusion of FFP or platelets, delivery of fetus
ASAP
◉ Why do we avoid abdominal palpation in HELLP syndrome?.
Answer: to reduce risk of subcapsular liver hematoma rupture
◉ Gestational diabetes.
Answer: hyperglycemia and glucose intolerance that develops
during pregnancy (after 20 weeks)
◉ 1hr glucose test.
Answer: we want it to be less than 130
◉ 3hr glucose test.
, Answer: <95 fasting, <180 1hr, <155 2hr, <140 3hr
◉ gestational diabetes risk factors.
Answer: >40, family hx of DM, prior macrosomic infant, obesity, htn,
glucosuria
◉ Fetal assessment for GDM.
Answer: NST done at 28 weeks, detailed US at 18 and 28 weeks, BPP
needed, strict kick count
◉ Target glucose levels for mom.
Answer: <100 fasting, <120 postprandial
◉ Preterm labor.
Answer: contractions that produce cervical changes after fetal
viability but before fetal maturity
◉ Terbutaline (Brethine).
Answer: tocolytic, contraindicated in severe gestational HTN and
cardiac disease, can cause tachycardia in mom and baby
◉ Magnesium sulfate.