Case Scenario (Preeclampsia)

Patient KMG is a 34 years old female, born October 11, 1987, Filipino, Roman Catholic,
married to PLG from Lomboy, Lapaz, Tarlac. Patient is currently cooking their dinner when
she suddenly felt low back pain and uterine contractions. She was hesitant to go to the
hospital at first but her husband convinced her to go to be sure if what she feels true labor.
For the brief clinical history, (+) labor pain, (+) vaginal bleeding, BP 180/100, (-) seizure.
Admitting diagnosis is T/C Preeclampsia PU 37-38 wks AOG. LMP was May 5, 2021, FHT is
145, IE: 4 cm. Patient has no history of any disease and no known allergies to food and/or
medicines. Her menarche was when she was 12, with regular menses, duration of her
menstruation is usually 4 days and she consumes 2 pads/day.

DOCTOR’S ODERS
ADMITTING ORDERS
-Admit patient to OB ward
-Secure consent for admission and management
-IVF: D5LRS 1L X 8 hrs
Diagnostics: CBC c PC, HBSAg, FBS, CREA, CXR PA, ABO Rh typing, UA, BUN, SGPT, SGOT
Therapeutics:
1. Hydralazine 5mg IV now then q 15 mins for BP160/100 max: 20 mg
2. MgSO4 4g SIVP now then start MgSO4 drip.
MgSO4 20g + D5W 500 cc x 50 cc/ hr via soluset
3. Cefazolin 2g IV ( ) ANST single dose only
4. HNBB 1 amp IV now
-Hook to 02 via NC at 3-4 lpm
-Insert IFC aseptically
-Monitor VS, FHT, POL q 1hr & record
-Monitor I&O q shift & record
-Maintain on left lateral decubitus position
-WOF MgSO4 toxicity: DTRs, RR 12, UO 30 cc/hr
-Seizure precaution
-Refer

POST PARTUM ORDERS

-S/P vacuum assisted delivery
-DAT once fully awake
-May transfer to ward
-IVF: D5LRS 1L + 10 units oxytocin x 10-15 gtts/min
-Medications:
1. Cefuroxime 500 mg/tab 1 tab BID
2. Metronidazole 500 mg/tab 1 tab TID
3. Iron + Folic Acid tab OD
4. Na Ascorbate + Zinc 2 tabs OD
5. Malunggay cap BID
6. PCT + TDL TID
7. Amlodipine 10 mg OD
8. Furosemide 40 mg IVP now then 20 mg q8 x 3 doses
9. Carboprost 250 mcg IM
-Monitor VS q15 mins for 1 hr; q 30 mins until stable; q 4 hrs thereafter
-Keep uterus well contracted. Massage PRN.
-WOF: profuse bleeding, hypotension, fever
-Advise daily perineal hygiene/care.
-Refer accordingly