Monday, May 27, 2024

MANAGEMENT OF SEVERE PRE-ECLAMPSIA

Table of Contents

REQUIREMENTS #

  1. Vital signs tray
  2. Delivery tray
  3. Induction tray
  4. Oxytocin
  5. Anticonvulsant e.g. Magnesium Sulphate
  6. Intravenous line tray
  7. IV Fluids e. g. Normal Saline or Ringer’s Lactate
  8. Urethral Catheter and Urine Bag
  9. Foetal monitor (manual /electronic)
  10. Intake and Output chart
  11. Oxygen Apparatus
  12. Suction Apparatus
  13. Perineal Pad
  14. Theatre Gown and Cap
  15. Consent Form
  16. Patella Hammer
  17. Urine Dipsticks
  18. Blood and Urine sample bottles
  19. Maternal and Child Health Record Book (Manual/Electronic)

STEPS #

  1. Establish rapport (refer steps)
  2. Explain procedure to client (refer steps)
  3. Explain to client the need to attend antenatal clinic and procedures involved
  4. Perform a rapid evaluation of the general condition of the woman, including vital signs
  5. Take history of the present and past illness from her relatives
  6. Ascertain gestational age to help in proper diagnosing of pre-eclampsia
  7. Maintain Infection Prevention and Control measures throughout management
  8. Perform general examination from head to toe
  9. Obtain urine sample and test for protein and sugar
  10. Take blood sample for BUE & Creatinine, FBC, Rh status, grouping and cross matching etc.
  11. Monitor vital signs, reflexes, foetal heart rate every hourly and record
  12. Gather equipment for convulsion management (airway, suction, mask and bag, nasal prongs, oxygen)
  13. Start anticonvulsant as per WHO/GHS protocols
  14. Pass indwelling urethral catheter to monitor urine output (at least 30 ml per hour) and proteinuria
  15. Discontinue anticonvulsive therapy if urine is less and infuse normal saline or Ringer’s Lactate solution at maintenance rate (100-125 ml/hour) but monitor for the development for pulmonary oedema
  16. Ensure safety of client by pulling up side rails (Never leave the woman alone because convulsion may follow soon)