Preyeklanpsi, Magnesium ak Reflèks Ou Tcheke yo

🧠 Poukisa sa enpòtan

PREYEKLANPSI se nouvo tansyon wo (sistolik 140 oswa plis OSWA dyastolik 90 oswa plis nan de mezi ki pran omwen 4 èdtan apa) apre 20 semèn ak pwoteyin nan pipi oswa atenn ògàn; karakteristik grav yo gen ladan yon presyon sistolik 160 oswa plis OSWA yon presyon dyastolik 110 oswa plis, maltèt grav, pwoblèm vizyon, doulè epigastrik oswa doulè nan kadran siperyè dwat, èdèm poumon ak plakèt ki ba. Sendwòm HELLP (emoliz, anzim fwa ki wo, plakèt ki ba) se yon fòm grav. EKLANPSI se preyeklanpsi ak kriz. MAGNESIUM SULFATE anpeche kriz: yo bay li IV ak yon ponp ak yon dòz chaj epi apre antretyen, epi enfimyè a siveye TOKSISITE: pèt REFLÈKS TANDON PWOFON yo (siy ki pi bonè a), respirasyon anba 12, pwodiksyon pipi anba 30 mL/hr, ak yon nivo magnesium ki pi wo pase limit terapetik apeprè 4 a 7 mEq/L. Kenbe CALCIUM GLUCONATE bò kabann nan kòm antidòt la. Medikaman kont tansyon wo pou presyon grav yo gen ladan labetalol, hydralazine ak nifedipine. Swen enfimyè: yon chanm trankil ki pa twò klere, prekosyon pou kriz, kouche sou kote, kontwòl strik sou sa k antre ak sa k soti, peze chak jou, ak siveyans fetis la. Pandan yon kriz, pwoteje pasyan an, vire li sou kote, epi pa kenbe li fòs; apre li, evalye wout lè a, eta fetis la ak si gen dekòlman plasenta. Akouchman se remèd la, epi magnesium anjeneral kontinye pou apeprè 24 èdtan aprè akouchman.

PREECLAMPSIA is new hypertension (systolic 140 or higher OR diastolic 90 or higher on two readings at least 4 hours apart) after 20 weeks with proteinuria or organ involvement; severe features include a systolic pressure of 160 or more OR a diastolic pressure of 110 or more, severe headache, visual disturbances, epigastric or right upper quadrant pain, pulmonary edema and low platelets. HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) is a severe variant. ECLAMPSIA is preeclampsia with seizures. MAGNESIUM SULFATE prevents seizures: it is given IV by pump with a loading dose then maintenance, and the nurse monitors for TOXICITY: loss of DEEP TENDON REFLEXES (the earliest sign), respirations under 12, urine output under 30 mL/hr, and a magnesium level above the therapeutic range of about 4 to 7 mEq/L. Keep CALCIUM GLUCONATE at the bedside as the antidote. Antihypertensives for severe pressures include labetalol, hydralazine and nifedipine. Nursing care: quiet dim room, seizure precautions, side-lying, strict intake and output, daily weights, and monitoring the fetus. During a seizure, protect the client, turn her to the side, and do not restrain; after it, assess the airway, fetal status and for placental abruption. Delivery is the cure, and magnesium usually continues for about 24 hours postpartum.

🏥 Nan lavi reyèl

🔨 Nan sizyèm èdtan yon perfusion magnesium: enfimyè a tape tandon patèl la epi li pa jwenn anyen, respirasyon yo se 11, epi sak Foley a gen 20 mL ki soti nan dènye èdtan an. Yo kanpe perfusion an, yo bay calcium gluconate dapre lòd la, epi yo rele founisè a. Kriz magnesium lan te anpeche a te reyèl; arè respiratwa li te prèt pou koze a te evite gras a yon tcheke reflèks.

🔨 Hour six of a magnesium infusion: the nurse taps the patellar tendon and gets nothing, respirations are 11, and the Foley bag holds 20 mL from the last hour. The infusion is stopped, calcium gluconate is given per order, and the provider is called. The seizure the magnesium prevented was real; the respiratory arrest it nearly caused was prevented by a reflex check.

📌 Sa pou retni

• Karakteristik grav: 160/110, maltèt, chanjman vizyon, doulè epigastrik, plakèt ki baSevere features: 160/110, headache, visual changes, epigastric pain, low platelets
• Toksisite magnesium: reflèks absan an premye, apre RR anba 12; pipi anba 30 mL/hr pèmèt magnesium akimile, kidonk rapòte liMagnesium toxicity: absent reflexes first, then RR under 12; urine under 30 mL/hr lets magnesium build up, so report it
• Calcium gluconate bò kabann nan; akouchman se remèd laCalcium gluconate at the bedside; delivery is the cure

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