Box 1. Order Set for severe Intrapartum or Postpartum Hypertension Initial First-Line Management with Labetalol
Notify physician if systolic blood pressure (BP) mea- surement is greater than or equal to 160 mm Hg or if diastolic BP measurement is greater than or equal to Hg Institute fetal surveillance if undelivered and fetus is viable If severe BP elevations persist for 15 minutes or more, administer labetalol (20 mg intravenously over 2 minutes) Repeat BP measurement in 10 minutes and record results f either BP threshold is still exceeded, administer labetalol (40 mg IV over 2 minutes). If BP is below threshold, continue to monitor BP closely. Repeat BP measurement in 10 minutes and record results. If either BP threshold is still exceeded, administer labetalol (80 mg IV over 2 minutes). If BP is below threshold, continue to monitor BP closely. Repeat BP measurement in 10 minutes and record results If either BP threshold is still exceeded, administer hydralazine (10 mg IV over 2 minutes). If BP is below threshold, continue to monitor BP closely. Repeat BP measurement in 20 minutes and record results If either BP threshold is still exceeded, obtain emer- gency consultation from maternal fetal medicine, internal medicine, anesthesia, or critical care subspe- cialists. Give additional antihypertensive medication per spe- cific order. Once the aforementioned BP thresholds are achieved, repeat BP measurement every 10 minutes for 1 hour then every 15 minutes for 1 hour, then every 30 minutes for 1 hour, and then every hour for 4 hours Institute additional BP timing per specific order. "Please note there may be adverse effects and contraindications Data from National Heart, Lung, and Blood Institute. The sev enth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. NIH Publication No. 04-5230. Bethesda (MD): NHLBI; 2004. nhlbi nih.gov/files/docs/guidelines/jnc Available at 7full.pdf. Retrieved 0ctober 14, 2014
1 กล่อง สั่งชุด Intrapartum รุนแรงหรือหลังคลอดความดันโลหิตเริ่มต้นบรรทัดแรกจัดการกับ LabetalolNotify physician if systolic blood pressure (BP) mea- surement is greater than or equal to 160 mm Hg or if diastolic BP measurement is greater than or equal to Hg Institute fetal surveillance if undelivered and fetus is viable If severe BP elevations persist for 15 minutes or more, administer labetalol (20 mg intravenously over 2 minutes) Repeat BP measurement in 10 minutes and record results f either BP threshold is still exceeded, administer labetalol (40 mg IV over 2 minutes). If BP is below threshold, continue to monitor BP closely. Repeat BP measurement in 10 minutes and record results. If either BP threshold is still exceeded, administer labetalol (80 mg IV over 2 minutes). If BP is below threshold, continue to monitor BP closely. Repeat BP measurement in 10 minutes and record results If either BP threshold is still exceeded, administer hydralazine (10 mg IV over 2 minutes). If BP is below threshold, continue to monitor BP closely. Repeat BP measurement in 20 minutes and record results If either BP threshold is still exceeded, obtain emer- gency consultation from maternal fetal medicine, internal medicine, anesthesia, or critical care subspe- cialists. Give additional antihypertensive medication per spe- cific order. Once the aforementioned BP thresholds are achieved, repeat BP measurement every 10 minutes for 1 hour then every 15 minutes for 1 hour, then every 30 minutes for 1 hour, and then every hour for 4 hours Institute additional BP timing per specific order. "Please note there may be adverse effects and contraindications Data from National Heart, Lung, and Blood Institute. The sev enth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. NIH Publication No. 04-5230. Bethesda (MD): NHLBI; 2004. nhlbi nih.gov/files/docs/guidelines/jnc Available at 7full.pdf. Retrieved 0ctober 14, 2014
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