Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate

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Miriam Wahrman
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Included In This Lesson

Study Tools For Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate

Preeclampsia Pathochart (Cheatsheet)
Pitting Edema (Image)
Preeclampsia Assessment (Picmonic)
Preeclampsia Interventions (Picmonic)
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Outline

Overview

  1. Hypertensive disorder
  2. Proteinuria
  3. After 20 weeks gestation

Nursing Points

General

  1. A woman may or may not be symptomatic but will have elevated blood pressures and proteinuria
  2. Blood pressures
    1. 140/90 or more x 2, 4 hours apart
    2. Or a systolic 160 mmhg or more
    3. Or a diastolic of 90 mmhg or more
      1. So remember 140/90 and 160/90

Assessment

  1. So what does this patient look like?
    1. A sudden increase in edema
      1. Hands and face
    2. Sudden weight gain
      1. Excess fluid retention
    3. Complaints of headache
    4. Complaints of epigastric or RUQ pain
    5. Vision changes
      1. Serious symptom of preeclampsia
      2. From swelling and irritation of the brain and the CNS
    6. Proteinuria
  2. Fetal assessment
    1. Intrauterine growth restriction (IUGR)
      1. Placental blood flow is not at its best

Therapeutic Management

  1. Delivery of the baby is the only cure
  2. Magnesium sulfate is given prophylactically
    1. Seizure prevention
  3. Some antihypertensive drugs might be given to manage BP

Nursing Concepts

  1. Reproduction
  2. Perfusion

Patient Education

  1. Call MD if nausea, vision changes, headaches, epigastric pain or increased swelling occur
  2. Perform daily kick counts
  3. Home BP checks

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Transcript

In this lesson I will explain pre-eclampsia and your role in providing safe card to this patient

Preeclampsia is hypertension that occurs in pregnancy after after 20 weeks gestation. The patient will have proteinuria. This is a must have! If there is no protein that it is only gestational hypertension. Preeclampsia is a progression and could progress and worsen. Delivery is the only treatment or cure.

So for preeclampsia we say a patient must be hypertensive. Let’s look at what ranges classify as pre-eclamptic pressures. Blood pressure must be 140/90 or more times 2, 4 hours apart. So they will check it again to see if it has come down and hopefully it has but 140/90 is one option. The other is a systolic of 160 mmhg or more or a diastolic of 90 mmhg or more. So to make this easier just remember 140/90 and 160/90.

So what does this patient look like on assessment? A woman will usually present with a sudden increase in edema especially in hands and face. Why does this happen? Fluid is being retained because the body is not filtering or pumping correctly. There is sudden weight gain. Why? Because of excess fluid retention. The heart is not pumping as effectively so it all backs up. They have complaints of headaches because of the high blood pressure. There is a change in pressure from normotensive to hypertensive. Another assessment finding is complaints of epigastric or right upper quadrant pain. In preeclampsia there is Inflammation is occuring in the body. The liver is inflamed which causes elevated liver enzymes and abdominal pain. Vision changes can also occur, but this is a very dangerous symptom. This occurs from swelling and irritation of the brain and the central nervous symptom.Proteinuria is our must have symptom. So why is that in the urine? The body is sick and inflamed so the kidney filter that keeps protein in the blood is damaged so protein is spilled into the urine

Our management of this patient is really going to revolve around safety. What is the safest treatment for the patient and baby. Delivery of the baby is the only cure for pre-eclampsia. If it is safe to keep the patient pregnant longer and safe for the baby then we will. In this case the patient can be kept in the hospital and receive IV Magnesium sulfate. This is given prophylactically to prevent seizures. Remember how I said preeclampsia is a progressive disease so they can get worse and remember also how we have an inflamed CNS? This can cause seizure. If a seizure occurs the patient is now said to be eclamptic. When seizures occurs the disease process has now advanced and is called eclampsia.. A little side note is that a side effect of Mag sulfate is it lowers blood pressure so that is terrific, right?!! Some antihypertensive drugs might be given to manage blood pressure if magnesium sulfate is not lowering it enough or if they are trying to manage without magnesium. Let’s also talk about the fetus. Fetal assessment needs to be done. This will be looking at blood flow through the placenta to ensure the fetus is getting good blood flow. Also fetal measurements to make sure the baby is growing ok. The fetus can have intrauterine growth restriction known as IUGR. With preeclampsia the fetus doesn’t grow as well hence growth restriction this is because blood flow into the placenta is not at its best. We need good healthy blood flow to come through the placenta to give nutrients to grow the fetus.

The preeclamptic patient needs to receive education on when to call the MD. So if there is nausea, vision changes, headaches, epigastric pain or swelling occur then she should call. They need to be performing daily kick counts. Remember with preeclampsia there is not great blood flow to the placenta which creates an unhealthy environment for that fetus. Kick counts will help us to know if the fetus is still healthy in that environment. The patient should attempt to get 10 kicks in a two hour time frame and notify if they aren’t. She should be taught how to do home blood pressure checks and report readings of 140/90 or a systolic of 160 or more or a diastolic of 90 or more.

Reproduction and perfusion are our nursing concepts. We are worried about the perfusion to the organs and through the placenta.

Ok so our key points. If you remember these you will understand pre-eclampsia. A patient has hypertension. Her blood pressures are 140/90 or systolic over 160 or diastolic over 90. She has proteinuria. This is a MUST! If she has no protein she is not preeclamptic. Remember P & P. Preeclampsia and Protein. The patient is over 20 weeks pregnant. Magnesium sulfate is our drug of choice. This is for seizure prevention but remember a side effect is lowering blood pressure. Our last key point is delivery. This is the only cure.

Make sure you check out the resources attached to this lesson and be sure to review the different hypertensive disorders so you can differentiate between them. Now, go out and be your best selves today. And, as always, happy nursing.

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Concepts Covered:

  • Basics of Sociology
  • Statistics
  • Communication
  • Fundamentals of Emergency Nursing
  • Musculoskeletal Disorders
  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient
  • Medication Administration
  • Gastrointestinal Disorders
  • Pregnancy Risks
  • Labor Complications
  • Factors Influencing Community Health
  • Respiratory Disorders
  • Emergency Care of the Neurological Patient
  • EENT Disorders
  • Newborn Complications
  • Documentation and Communication
  • Preoperative Nursing
  • Legal and Ethical Issues
  • Adult
  • Substance Abuse Disorders
  • Hematologic Disorders
  • Musculoskeletal Trauma
  • Intraoperative Nursing
  • Microbiology
  • Disorders of Pancreas
  • Oncology Disorders
  • Anxiety Disorders
  • Neurologic and Cognitive Disorders
  • Personality Disorders
  • Basics of NCLEX
  • Studying
  • Newborn Care
  • Basics of Mathematics
  • Note Taking
  • Integumentary Disorders
  • Emergency Care of the Trauma Patient
  • Respiratory Emergencies
  • Developmental Considerations
  • Digestive System
  • Lower GI Disorders
  • Central Nervous System Disorders – Brain
  • Postpartum Care
  • Basic
  • Infectious Respiratory Disorder
  • Integumentary Disorders
  • Eating Disorders
  • Circulatory System
  • Cardiovascular Disorders
  • Test Taking Strategies
  • Musculoskeletal Disorders
  • EENT Disorders
  • Postoperative Nursing
  • Neurological Emergencies
  • Cognitive Disorders
  • Concepts of Population Health
  • Community Health Overview
  • Noninfectious Respiratory Disorder
  • Delegation
  • Depressive Disorders
  • Terminology
  • Postpartum Complications
  • Vascular Disorders
  • Nervous System
  • Upper GI Disorders
  • Renal and Urinary Disorders
  • Developmental Theories
  • Fetal Development
  • Endocrine and Metabolic Disorders
  • Prenatal Concepts
  • Trauma-Stress Disorders
  • Psychological Emergencies
  • Adulthood Growth and Development
  • Childhood Growth and Development
  • Prenatal and Neonatal Growth and Development
  • Renal Disorders
  • Hematologic Disorders
  • Liver & Gallbladder Disorders
  • Tissues and Glands
  • Disorders of Thermoregulation
  • Urinary Disorders
  • Urinary System
  • Shock
  • Labor and Delivery
  • Oncologic Disorders
  • Emotions and Motivation
  • Peripheral Nervous System Disorders
  • Bipolar Disorders
  • Infectious Disease Disorders
  • Immunological Disorders
  • Sexually Transmitted Infections
  • Disorders of the Thyroid & Parathyroid Glands
  • Male Reproductive Disorders
  • Central Nervous System Disorders – Spinal Cord
  • Female Reproductive Disorders
  • Acute & Chronic Renal Disorders
  • Prioritization
  • Somatoform Disorders
  • Pediatric
  • Perioperative Nursing Roles
  • Concepts of Pharmacology
  • Psychotic Disorders
  • Concepts of Mental Health
  • Neurological Trauma
  • Health & Stress
  • Respiratory System

Study Plan Lessons

Lab Panels – The Basics and What YOU Need to Know 2 – Live Tutoring Archive
Fundamentals Course Introduction
Legal & Ethical Issues in ER
Nursing Care and Pathophysiology of Osteoporosis
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
3rd Degree AV Heart Block (Complete Heart Block)
6 Rights of Medication Administration
Abdomen (Abdominal) Assessment
Abortion in Nursing: Spontaneous, Induced, and Missed
Abruptio Placentae (Placental abruption)
Abuse
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Acute Bronchitis
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Autism Spectrum Disorders
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Base Excess & Deficit
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How to Write a Nursing Care Plan
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Magnesium Sulfate
Magnesium Sulfate in Pregnancy
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NG Tube Medication Administration
Normal Sinus Rhythm
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Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology for Chlamydia (STI)
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology for Crohn’s Disease
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Diverticulosis – Diverticulitis
Nursing Care and Pathophysiology for Gonorrhea (STI)
Nursing Care and Pathophysiology for Gout
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
Nursing Care and Pathophysiology for Hemorrhoids
Nursing Care and Pathophysiology for Herpes Simplex (HSV, STI)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Nursing Care and Pathophysiology for Human Papilloma Virus (HPV STI)
Nursing Care and Pathophysiology for Hyperparathyroidism
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Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Lyme Disease
Nursing Care and Pathophysiology for Male Infertility
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Osteomyelitis
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology for Parkinsons
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Polycystic Ovarian Syndrome (PCOS)
Nursing Care and Pathophysiology for Pulmonary Embolism
Nursing Care and Pathophysiology for Rhabdomyolysis
Nursing Care and Pathophysiology for Scleroderma
Nursing Care and Pathophysiology for Seizure
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology for Sickle Cell Anemia
Nursing Care and Pathophysiology for Syphilis (STI)
Nursing Care and Pathophysiology for Testicular Torsion
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Nephrotic Syndrome
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology of Renal Calculi (Kidney Stones)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care Delivery Models
Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage
Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Anxiety
Nursing Care Plan (NCP) for Appendicitis
Nursing Care Plan (NCP) for Decreased Cardiac Output
Nursing Care Plan (NCP) for Gastroesophageal Reflux Disease (GERD)
Nursing Care Plan (NCP) for Glaucoma
Nursing Care Plan (NCP) for Hepatitis
Nursing Care Plan (NCP) for Herpes Zoster – Shingles
Nursing Care Plan (NCP) for Influenza
Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Neural Tube Defect, Spina Bifida
Nursing Care Plan (NCP) for Neutropenia
Nursing Care Plan (NCP) for Pediculosis Capitis / Head Lice
Nursing Care Plan (NCP) for Pericarditis
Nursing Care Plan (NCP) for Pneumonia
Nursing Care Plan (NCP) for Skull Fractures
Nursing Care Plan (NCP) for Somatic Symptom Disorder (SSD)
Nursing Care Plan (NCP) for Urinary Tract Infection (UTI)
Nursing Care Plan for (NCP) Autism Spectrum Disorder
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Nutrition (Diet) in Disease
Nutrition Assessments
Nutrition in Pregnancy
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Osteosarcoma
Outline Question Method (Note taking)
Ovarian Cancer
Pain and Nonpharmacological Comfort Measures
Paranoid Disorders
Parasympatholytics (Anticholinergics) Nursing Considerations
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Pediculosis Capitis
Penetrating Abdominal Trauma
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Perioperative Nursing Roles
Peripheral Vascular Assessment
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Personality Disorders
Pertussis – Whooping Cough
Pharmacology Course Introduction
Phenylketonuria
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Pituitary Adenoma
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Postpartum Hematoma
Postpartum Hemorrhage (PPH)
Postpartum Physiological Maternal Changes
Potassium-K (Hyperkalemia, Hypokalemia)
PPE Donning & Doffing
Practice Settings
Precipitous Labor
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Preoperative (Preop) Nursing Priorities
Preoperative (Preop)Assessment
Pressure Line Management
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Preterm Labor
Prioritization
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Provider Phone Calls
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R – Real-Life
Radiation Cancer Treatment
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Renal (Kidney) Failure Labs
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Respiratory Acidosis (interpretation and nursing interventions)
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Rh Immune Globulin (Rhogam)
Rh Immune Globulin in Pregnancy
Routine Neuro Assessments
Rubeola – Measles
Safety Checks
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Sepsis Concept Map
Shift change and Patient handoff
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The 5-Minute Assessment (Physical assessment)
The EKG (ECG) Graph
The Medical Team
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Thrombocytopenia
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Transient Tachypnea of Newborn
Transition To Practice
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Trauma Survey
Triage in the ER
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Types of Exercise
Types of Schizophrenia
Umbilical Hernia
Urinary Elimination
Using Aseptic Technique
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What Guides Nurses Practice
What is CCMM?
White Blood Cell (WBC) Lab Values
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Wound Care – Dressing Change
Wound Care – Selecting a Dressing
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