• Skip to main content
  • Skip to primary sidebar
  • Skip to footer

QD Nurses

QD Nurses - Every Day Nurses - NCLEX Review Articles, NCLEX Study Guides, NCLEX Prep for Nursing Students, Nurses, and Healthcare Professionals

  • About
  • Education
  • Social
  • Reviews
  • Contact Us
You are here: Home / Maternal-Neonatal / Maternity Nursing Review: Preeclampsia & Eclampsia

Maternity Nursing Review: Preeclampsia & Eclampsia

posted on February 1, 2021

Two of the most common complications during pregnancy are preeclampsia and eclampsia. To help prevent further danger to both the mother and fetus, nurses should be highly knowledgeable about these two conditions and skilled enough to apply proper nursing care. In this article, we will talk about the following topics to help you with your “preeclampsia and eclampsia” review:

  • Preeclampsia
  • Signs and Symptoms of Preeclampsia
  • Signs and Symptoms of Eclampsia
  • Diagnostic Tests of Preeclampsia
  • Risk factors of Preeclampsia
  • Causes of Preeclampsia
  • Complications of Preeclampsia
  • Medical Management
  • Nursing Responsibility

Preeclampsia

Preeclampsia is characterized as a hypertensive disorder that developed as a complication of pregnancy. The disorder begins as early as the 20th week, and the pregnant mother has a normal blood pressure the weeks prior or before being pregnant.

Postpartum Preeclampsia

Postpartum preeclampsia occurs when the mother develops hypertension after childbirth. This is a rare condition where blood pressure is elevated and there is excess protein in the urine after childbirth. 

Signs and Symptoms of Preeclampsia

It is the nurse’s responsibility to monitor signs of preeclampsia and report it to the attending physician immediately. The nurse should look out for signs and symptoms of preeclampsia such as:

  • Elevated blood pressure: 140/90 mmHg taken six hours apart
  • Proteinuria: 1+ or 2+ using a Reagent Test Strip
  • Weight gain: More than 2lbs per week during the second trimester or 1lb per week on the third trimester
  • Low platelet
  • Signs of impaired liver
  • Signs of kidney problems
  • Visual disturbances
  • Headache
  • Pulmonary edema

Signs and Symptoms of Eclampsia

When preeclampsia is not managed properly, it may lead to eclampsia which can be fatal to the mother and the fetus. The nurse should look for signs and symptoms such as:

  • Blood Pressure reading: 160/110 mmHg taken six hours apart
  • Proteinuria: 3+ or 4+ 
  • Severe fluid retention or edema: Puffy hands and face
  • Oliguria due to impaired kidney function as manifested by urine output is less than 400 mL per day
  • Elevated creatinine
  • Blurred vision
  • Fluid retention
  • Epigastric pain
  • Thrombocytopenia
  • Seizures

To remember this well, the three clinical manifestations of eclampsia are HYPERTENSION, EDEMA, and PROTEINURIA. When three of these signs and symptoms appear, assess further data to confirm the presence of preeclampsia.

Diagnostic Tests for Preeclampsia:

If the physician suspects of the presence of preeclampsia, the confirmatory tests are:

  • Liver functions (ALT and AST): To determine the presence or extent of liver damage.
  • Kidney functions (BUN, creatinine, and Uric Acid): To determine the presence of kidney malfunction.
  • Platelets: To determine the presence of thrombocytopenia.
  • Urinalysis: The urine is checked for the presence of proteinuria.
  • Fetal Ultrasound: To closely monitor the growth of the fetus.
  • Nonstress Test: To monitor the heart rate of the fetus.
  • Biophysical profile: An ultrasound measuring the breathing, movement, muscle tone, and amniotic fluid of the fetus.

Risk factors of Preeclampsia

Keep in mind that preeclampsia is pregnancy-induced hypertension, which means it develops as a complication brought by pregnancy. Some of the risk factors are:

  • Preeclampsia on previous pregnancy
  • Family history of preeclampsia
  • Presence of chronic hypertension before pregnancy
  • First pregnancy
  • Women above 35 years old
  • Obese women
  • Multiple pregnancies
  • Interval of pregnancy (e.g., first pregnancy and second pregnancy has a 10-year difference)
  • Different father of previous and next pregnancy
  • Diabetes
  • Kidney disease
  • In vitro fertilization

Causes of Preeclampsia

It starts with the development of new blood vessels to adequately supply blood flow to the placenta. When these blood vessels do not develop or function the way they should, this causes elevated blood pressure and preeclampsia.

The new blood vessels for women with preeclampsia are narrower than the normal size. The new blood vessels could not react to hormone stimulation as well. This leads to a limited supply of blood to the placenta as the circulatory system puts in more effort to pump blood and raise the blood pressure.

The abnormal development of these blood vessels may be caused by insufficient blood supply to the uterus, damage to certain blood vessels, immune system problems, and genetic predisposition. 

Complications of Preeclampsia

Now that we are aware of the causes, risk factors, and signs and symptoms of preeclampsia, the nurse must be knowledgeable of the complications of the disorder. The complications of preeclampsia are:

  • HELLP Syndrome: Hemolysis, Elevated Liver enzymes, and Low Platelets
  • Eclampsia: Eclampsia is a severe form of preeclampsia that can lead to convulsion. Seizures occurring in eclampsia may lead to coma or death. 
  • Premature placental separation or abruption
  • Restricted fetal growth

Medical Management

  • Infant Delivery: When preeclampsia is prolonged and is left untreated, it can lead to life-threatening complications to both the mother and the fetus. The recommended treatment for preeclampsia is to deliver the fetus. 

If it is too early to deliver the fetus, the physician and mother need to take extra precautions through the pregnancy until the baby is prepared for delivery. When preeclampsia is not managed accordingly, it may lead to eclampsia.

  • Magnesium Sulfate: If the fetus is mature enough for labor and delivery, the physician may recommend childbirth. If not, there are control measures to decrease the risk of seizure.

The drug of choice in decreasing seizure activity is Magnesium Sulfate. The nurse needs to monitor the mother for Magnesium Sulfate toxicity by checking decreased or absent reflexes. When Magnesium Sulfate toxicity occurs, the nurse should be prepared with the antidote: Calcium Gluconate.

  • Medications to reduce hypertension: To prevent the occurrence of eclampsia, the doctor will most likely prescribe antihypertensive medications like Hydralazine, Labetalol, or Nifedipine.

Nursing Responsibility

The nurse must be responsible for monitoring further signs and symptoms to ensure the safety of both the mother and the baby and for promoting comfort. The nurse should be responsible for:

  • Monitoring vital signs especially blood pressure.
  • When prescribed Magnesium Sulfate, monitor for absence or decreased reflexes. 
  • Monitor intake and output, especially the urinary output for signs of kidney impairment. If the urinary output is less than 30ml per hour, this indicates that the kidneys are not perfusing well.
  • Assess for edema: face, extremities, and fingers
  • Recumbent position of the mother aide in sodium secretion
  • Ensure proper nutrition of the mother, and decrease sodium intake in the diet.
  • Monitor CNS status, hyper reflexes, vision changes, headache, and ankle clonus as signs of seizure.
Share on Facebook Share
Share
Share on Pinterest Share
Share
Share on Email Share
Share
Share on Messenger Share
Share
Total 0 Shares

Filed Under: Adult Care, Lymphatic System, Maternal-Neonatal Tagged With: eclampsia, maternity, maternity nursing, maternity nursing review, preeclampsia

Primary Sidebar

My digital products are designed to be easy-to-follow and delivered in a self-paced format. My latest product - the Prep Ultimate - contains Study Guides and Digital Flashcards

Get My NCLEX Prep Ultimate

Start your journey to passing the NCLEX below. Sign up today and I'll send my free infection control study guide to your email for download.

By signing up below, you agree to the Privacy Policy and confirm that your information is accurate.

More to See

Fluid and Electrolytes Nursing Review

Fluid and Electrolytes: Nursing Review

Standard and Transmission-Based Precautions

Standard and Transmission-Based Precautions

Septic Shock Nursing Review

Nursing Review: 6 Important Facts To Know About Septic Shock

COVID-19

Nursing Review: 11 Important Facts to Know About COVID-19

HIV/AIDS

Nursing Review: Learn More About the 3 Stages of HIV Infection

More Posts from this Category

  • Facebook
  • Instagram
  • Pinterest
  • Twitter
  • BUZZ
  • ATI Testing
  • NCLEX
  • ADULT CARE
    • Cardiovascular
    • Endocrine
    • Gastrointestinal
    • Genitourinary
    • Hematologic & Immune
    • Integumentary
    • Musculoskeletal
    • Neurosensory
    • Respiratory
  • FUNDAMENTALS
  • PSYCHIATRIC
  • PEDIATRIC CARE
    • Endocrine
    • Gastrointestinal
    • Genitourinary
    • Growth & Development
    • Hematologic & Immune
    • Musculoskeletal
    • Neurosensory
    • Respiratory
  • MATERNAL-NEONATAL
    • Antepartum
    • Intrapartum
    • Neonatal
  • NURSING SCIENCE
  • EMT

Footer CTA

Join over 1,500 happy students!

Get 160 FREE Digital Flashcards & My FREE Infection Control Study Guide

Learn More
  • Privacy Policy
  • Return Policy
  • Terms of Service
  • Contact Us

Copyright © 2023 QD Nurses. All Rights Reserved.

X
Subject:
Message:
Ajax loader
We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. By clicking “Accept”, you consent to the use of ALL the cookies.
Do not sell my personal information.
Cookie SettingsAccept
Manage consent

Privacy Overview

This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.
Necessary
Always Enabled
Necessary cookies are absolutely essential for the website to function properly. These cookies ensure basic functionalities and security features of the website, anonymously.
CookieDurationDescription
cookielawinfo-checkbox-analytics11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics".
cookielawinfo-checkbox-functional11 monthsThe cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional".
cookielawinfo-checkbox-necessary11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-others11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other.
cookielawinfo-checkbox-performance11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance".
viewed_cookie_policy11 monthsThe cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.
Functional
Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features.
Performance
Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors.
Analytics
Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc.
Advertisement
Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. These cookies track visitors across websites and collect information to provide customized ads.
Others
Other uncategorized cookies are those that are being analyzed and have not been classified into a category as yet.
Save & Accept
Share with friends
Share on Facebook Share
Share
Share on Pinterest Share
Share
Share on Email Share
Share
Share on Messenger Share
Share