Hyperemesis of gravidarum

1st Trimester

for this trimester Nausea and vomiting is common

2nd and 3rd Trimester

Nausea and vomiting should not be experience by the pregnant woman within this trimester

hypokalemia and hyponatremia

what are shown in the laboratory electrolytes test results?

Concentrated urine output

urinalysis will show?

ketones

When your body always breaks down fats and proteins it will lead to?

>1.025

what is the Elevated urine specific gravity

metabolic acidosis

pag tumataas ang ketones sa dugo it leads to this and na it will cause death.

plasma

what decrease in the CBC?

hematocrit and hemoglobin

what increase in the CBC?

IV fluids, TPN, Antiemetics, anatacids and diphenhydramine

what are the management for Hyperemesis of gravidarum?

IV Fluids

this management is for dehydration

Total parenteral nutrition (TPN)

this management is to to boost the immune system and to maintain nutrition

Antiemetics

this management is to control vomiting

Antacids

this management is to neutralize acid in the stomach

Diphenhydramine

this management is for sedative or relaxation effect

Black American Woman, Obesem Diabetes Mellitus, Poor economic status, History of cardiovascular disorder

Risk Factors of Pregnancy Induced Hypertension

Vasoconstriction

Effect on the fetus is IUGR leading to a lot of complications

140/90

For us to consider the vasoconstriction sa may gestational hypertension dapat yung BP niya is?

glomerular filtration

if the kidney is damaged this diminished

Protein

this should be in the interstitial spaces meaning nasa labas ng vascular space or nasa labas ng ugat.

diuretic

what is the management for cerebral edema?

Gestational Hypertension, Mild pre-eclampsia, Severe pre-eclampsia, eclampsia

Types of Pregnancy Induced Hypertension

Gestational Hypertension

Increased blood pressure and there is No proteinuria

Mild pre-eclampsia

Hypertension, Proteinuria, Protein +1 +2, and pt will undergo 24hrs urine protein

Mild pre-eclampsia

Edema, Decreased urine output, Peripheral edema, Pitting Edema +1 +2

Severe pre-eclampsia

Bp is more than 160/110

Severe pre-eclampsia

Proteinuria is +3 +4, Generalized Edema, Pitting Edema +3 +4

Eclampsia

Seizure, Hypertension, proteinuria, Pitting Edema +3 +4

Severe headache, Tonus ankle, Blurred vision

Signs and symptoms na mag l’lead na sa seizure si pt

Heparin

To prevent clogging

Heparin

Discontinue when pt is on term pregnancy

Magnesium Sulfate, Hydralazine, Diazepam, Morphine. Calcium Gluconate

what are the Medication to prevent eclampsia

Magnesium Sulfate

To prevent seizure and To relax the muscle

Hydralazine

For vasodilation

Hydralazine

Pwede pagsabayin si magsul and this

5-10 mg per IV push

Diazepam

For sudden seizure

Diazepam

By IV push 5-10 mg, for sedation

Morphine

Overdose hanggang macoma

Calcium Gluconate

Antidote for magnesium sulfate toxicity

Magnesium Sulfate

this is also use to lower BP

Respiratory depression, Decreased urine output, Patella Reflexes, Serum Magnesium Level

what are we going to monitor when we use magsul?

Respiratory depression

Should not be lower than 12 bpm, should always be above 12 bpm

monitor every hour

Respiratory depression should be monitor every?

Decreased urine output

The urine output is less than 30ml per hour

Every hour

Decreased urine output should be monitor every

Patella Reflexes

Pag hindi nag jerk indication of toxicity and Pag nag hyperactive jerk indication of toxicity

4 hours

Patella Reflexes should be monitored Every?

Serum Magnesium Level

this is use to To see if nag t’toxicity

Every 8 hrs

Serum Magnesium Level should be monitored Every?

5 to 8 mg per 100 ML

what is the Therapeutic rangeof Serum Magnesium Level?