Pre-eclampsia: NCLEX Priorities
Pre-eclampsia: BP + proteinuria, severe features, magnesium sulfate, delivery as cure.
Pre-eclampsia is BP >140/90 after 20 weeks + proteinuria or organ dysfunction. NCLEX hammers mag sulfate.
Diagnosis
BP ≥140/90 after 20 weeks + proteinuria (≥300 mg/24h) OR organ dysfunction (renal, liver, hematologic, pulmonary, neurologic).
Severe features
BP ≥160/110, severe headache, visual changes, RUQ pain, low platelets, elevated liver enzymes, AKI, pulmonary edema.
Treatment
Magnesium sulfate for seizure prophylaxis. Antihypertensives (labetalol, hydralazine, nifedipine). Delivery is the only cure, timing depends on severity and gestational age.
Postpartum
Continue mag 24h post-delivery. Risk persists. Monitor BP.
Frequently asked
Mag toxicity signs?
Loss of patellar reflex (first), RR <12, urine <30 mL/h. Antidote: calcium gluconate.
HELLP syndrome?
Hemolysis, Elevated Liver enzymes, Low Platelets. Severe pre-eclampsia variant. Deliver.
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