Evidence Based Medicine in Hatyai Hospital,Thailand: Assignment I

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�ҡ���Ӥѭ Case refer �ҡ þ.�ǹ��§ G1P0 GA 41 Wks by LMP with preeclampsia
����ѵԻѨ�غѹ Case G1P0 GA 41 Wks by LMP
4 ��. PTA ���ҡ�ûǴ��ͧẺ�պ� �Ǵ������������ �Ǵ�ء� 5 �ҷ� ��лǴ�ҡ���������� ����չ���Թ ������١���ʹ�͡�ҧ��ͧ��ʹ �֧� þ.�ǹ��§ ��� þ.�ǹ��§ BP �á�Ѻ 150/100 mmHg repeat ��ӡ��ѧ 150/100 mmHg ��������ҡ�����¹����� �Ҿ������ �ء����鹻�� ��Ǩ��ҧ����á�Ѻ lung:clear Rt=Lt,Ext:pitting edema 1+,neuron: no abnormal tone ��õ�Ǩ����� �硷� Vx,FHS 144/min pv: Cx dilate 3 cm.,eff 80%,station 0,MI ,urine albumin:3+
����ѡ�ҷ�����Ѻ��������� þ.LRS 1,000 cc.iv 80 cc/hr ��͹�觵���� 10%MgSo4 4 gm.IV slowly push then 50% MgSo4 10 gm IM �觩մ��⾡��ҧ�� 5 gm ��Т���觵� retain foley cath ,NPO
��û����Թ��͹�觵� ��ѧ�ҡ�� MgSo4 ��� RR 20/min,FHS 142/min,DTR 2+
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����ѵԡ�ýҡ����� Case G1P0 ANC ���ʶҹ�͹��������˭� �������͵��ᾷ��Ѵ����t 14 ���� �š�õ�Ǩ���ʹ VDRL:NR,HIV:neg,Hb 33%,35%
Review of system: pitting edema 1+
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��Ǩ��ҧ���: v/s BP 152/79 PR88/min RR22/min BT 37c BW 60 kg HT155cm.
General: pregnancy woman, good conscious
HEENT: no pale, no icteric sclera
HEART: normal s1s2, no murmur
LUNG: cler Lt=Rt , no adventitious sound
ABDOMEN:FH ¾>umbilicus,OL,engaged,FHS 140/min,UC: interval 3 min duration 40 sec
PV: Cx dilate 3 cm.,eff 1oo%,station -2,MI
LAB: CBC: Hb 11.7 Hct 35.06 Wbc 12,520 Plt.273,300 Neu 76.23 Lym 19.07
E�lyte: Na 152 K3.9 Cl 115Co2 23
Blood chemistry:glucose 84, BUN 7, Cr 0.7, Uric acid 5.8, Total protein 6.3, Albumin 3.4, Total bilirubin 0.5, SGOT 23, SGPT 15, ALP 323
UA:sp.gr. 1.018 wbc 3-5, rbc 50-100, protein 100 mg/dl, glucose:neg, blood 250 mg/dl
�����¤�ʹ normal labor ��á��˭ԧ ��.3,510 ���� Apgar 9,9,9
�ѭ�ҡ���ѡ�� ������ MgSo4㹼����� preeclempsia �ջ���ª��㹡�û�ͧ�ѹ����ѡ���ҡ�êѡ���������?
ased Medicine in Hatyai Hospital,Thailand: Assignment I