Essential Items are used to handle the complication or any emergency situation occurs due to high blood pressure due to preeclampsia.

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MUNEESWARI JEYACHANDRAN., MSC
NURSING
Labor and Delivery Room

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Pregnancy Induced Hypertension is
high blood pressure happened or
induced by pregnancy which is
otherwise called as preeclampsia.
Preeclampsia characterized by high
blood pressure, proteinuria, edema or
swelling, epigastric pain, decreased
reflex and urine output.
Always keep
PIH trolley
or kit at bedside
for
preeclampsia
patient.

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S. No Items Nos/ Size Rational or Uses Picture
A PIH TROLLEY CONTAINS
1 Blind insertion Airway
Device (BIAD) (or)
Oropharyngeal airway
Size 2, 3, 4.
Each 1
To keep the airway open to provide unobstructed
ventilation and to reduce the risk of aspiration.
PIH mother more prone to get Eclampsia (seizure) leads to
aspiration or obstructed ventilation.
2. Rebreather mask 1 Saves 1/3 of a person’s exhaled air.
Allows the patient to rebreathe some of CO2, act as way to
stimulate breathing.
Flow rate 8-10LPM upto 90% O2 concentration.
3 Yankeur suction 1 Use to suction oropharyngeal secretions in order to prevent
aspiration during eclamptic seizure.
Maintain patent airway.
Improve oxygenation by removing mucous secretions and
foreign material from the mouth and throat (Oropgarynx).
4 IV Cannula G16 (Grey)
IV Cannula G18 (Green)
IV Cannula G20 (Pink)
IV Cannula G22 (Blue)
5
5
5
3
For blood & rapid fluid administration but more painful.
Administer blood, pushing fluid rapidly, not painful.
Better for all IV Fluid infusion.
For small vein, and for temporary short infusion.
5 Tourniquet 1 Easily make the vein come out or visible.
6 Microbore tape 1 Secure the IV cannula and Foley’s catheter in situ.
7 IV RL
IV NS
IVF. Voluven
3
3
1
Replacing the fluids and electrolytes.
To pick up blood pressure for sudden hypotension.
To replace massive fluid exchange or volume expander.

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S. No Items Nos/ Size Rational or Uses Picture
8 IV Set
IV burette
2 each For controlled infusion of medications and IVF infusion.
To connect the medication to the needle inserted into the
patient.
Use to deliver a fixed volume of IV fluid at a fixed rate
usually added medications.
9 Disposal syringe 1ml.
Disposal syringe 2ml
Disposal syringe 5ml
Disposal syringe 10ml
Disposal syringe 20ml
Disposal syringe 50ml
3 each Used for giving test dose.
Used to inject fluid into or withdraw fluid from the body.
For IM injection administration.
Used for dilute antibiotic with NS or Distilled water.
Used to withdraw mass blood investigations.
Used for Mgso4 and labetalol infusion.
10
Needle 20 G Yellow
Needle 21 G Green
Needle 22 G Black small
3 each Regular walled pointed needles for IM, SC administration.
Drawing blood for investigation.
Used for ID, IM, IV and aspirate the medication.
11 Blood collection tubes
ETDA tube- violet color
Sodium citrate – Blue
Plain tube- red or yellow
2 Each To send CBC (violet), coagulation profile (blue), LFT RFT
(plain), Cross-matching blood samples (one plain tube and
Violet tube) for emergency situation.
To diagnose HELLP syndrome if LFT high, low platelet,
low HB.
Eclampsia extends blood clotting times.
12 Urine collection
container (small) or
24 hours urine container
or can
1 Collect midstream urine to identify the proteinuria and any
infection such as candida, E.coli and so on.
Sometimes, physician order 24 hours urine collection to
determine the amount of protein lost.
If more than 300mg protein in urine indicate
preeclampsia.

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S. No Items Nos/ Size Rational or Uses Picture
13 Foleys catheter
Size 12,14,16,
Each 1 To drain and measure continuous urine output if patient
under 24hours MgSo4 infusion.
Check hourly urine dipstick for protein.
Urine output should be 30ml/ hr is normal.
14 Reflex hammer 1 Deep tendon reflexes demonstrate homeostasis between
cerebral cortex and spinal cord.
Increase blood pressure will lead to increasing
hyperreflexia or disrupted.
PIH affect the blood supply to nervous system cause
irritable.
15. Sterile gloves
Size 6, 6.5, 7, 7.5,8, 8.5
Each 2 Use for all procedure in a sterile way to avoid and prevent
infection.
PIH is high risk to get infection.
Health care professional wear sterile gloves after handwash
and make sure dry hand.
16 Manual BP monitor 1 To check BP regularly
Confirm PIH if 3 continuous reading of more than 140/90.
(For continuous BP monitoring, use cardiac monitoring to
measure BP, Pulse, RR, SPO2 and Show continuous ECG.)
17 Adult Stethoscope 1 The stethoscope has two different heads to receive sound,
the bell and the diaphragm.
The bell is used to detect low-frequency sounds and
The diaphragm to detect high-frequency sounds.
Use of the diaphragm side in the measurement of blood
pressure, because it is easier to hold and covers a
greater area.

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S. No Items Nos/ Size Rational or Uses Picture
PIH medications in TROLLEY or TRAY
19 INJ. MgSO4 First choice Loading dose
4g MgSO4 in 42ml NS over 15-20minutes.
Maintenance Dose
25g MgSO4 in 450ml NS at 20ml/hr for 24hrs.
INJ. Labetalol Second
choice
If BP not controlled by Inj. MgSO4.
80ml water for injection +100mg Labetalol (Inj.Trandate)
Bolus: 20-80mg IV bolus Q10Min to maximum of 300mg
for rapid control of BP.
Infusion Dose: 0.5-2mg/min to maximum 2.4gm/day.
INJ. Hydralazine Third choice If severe PIH or BP not controlled by Inj. MgSO4 or
labetalol.
5-10 mg IV/IM initially then 5-10mg Q20-30min PRN.
Inj. Calcium Gluconate
10%
Antidote
1g / 10ml
If patient in respiratory depression in Overdose of Inj.
MgSO4.
If Respiration rate: 10 breaths/mint or less is called
respiratory depression.

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Cap. Nifedipine
(Ca channel blockers)
30-90mg
once daily
Treat hypertension and chest pain
Use to stop preterm delivery (<37Weeks)
Inj. Lidocaine 2% 1 ampule Local anesthesia used to make numbness on operative site
or suturing site.
Inj. Diazepam (Valium) 1 ampoule
10mg in 2ml
Used to stop seizures
Loading dose: - 4-6g (15-20min)
Maintenance dose: -1-2g/ hour as continuous IV.
Administer after Inj. Mgso4 infusion.
Inj. Lasix or
Furosemide
3 Nos.
40mg in 4ml
Used to reduce the bipedal edema due to hypertension.
Use after physician order, because may cause harm to the
baby by diminishing placental perfusion.
20. Sterile Mouth gag 1 To prevent aspiration during seizure.
Mouth gags used to protect the tongues of patients whilst
experiencing seizures in eclampsia