admit pt to labour ward- immediate priority - place pt on left lateral side to increase oerfusion to the uterus- start an iv

1L ringers- restrict fluid to 80ml/h to prevent fluid overload- insert a catheter and attach urine bag to monitor urine output and proteinuria- administer magsul to prevent seizures- dilute 4g of MgSO4 in a 200ml bag of NaCl and connect line correctly- infuse MgSo4 via iv for 20 mins- if pt is still in the facility after 4 hurs administer 5g of magsul via IM in each buttock- therefore the pt should have recieved a total of 14g of MGSO4 - give a stat oral dose of 1g of methyldopa po in order to lower bp- administer adalat 10mg po to lower bp - recheck bp. if bp higher than 160/110 then administer 2nd dose of adalat- repeat every 30 mins and 3 doses max can be admin- monitor bp, p and resp every 15 mins- monitor urine output and it should not be less than 25-30mls- discuss with dr at HR facility- book flying squad for patient

Spell: mid high risk