1. What are the major differences between gestational hypertension, preeclampsia and
eclampsia?
Gestational hypertension develops halfway through pregnancy around 20 weeks and is most
common in women pregnant for the first time. Diagnosed when blood pressure is higher than
140/90/
Preeclampsia – is also high blood pressure during pregnancy but can be fatal to the baby and
mother. It also causes damage to other organs. Also there is protein in he urine.
Eclampsia – is a complication preeclampsia characterized by seizures and coma.
2. What is the pathophysiology that leads to these conditions?
Gestational hypertension is caused by unknown factors.
Preeclampsia – This is cause by abnormal blood vessels in the placenta which cause insufficient
blood supply to the uterus and damaged blood vessels.
Eclampsia – Chromosome abnormality, immunologic defects, and placental infraction are all
possible causes.
3. What is HELLP syndrome and how does it differ from preeclampsia?
HELLP syndrome is a highly fatal liver disorder which is a type of preeclampsia. It stands for
Hemolysis elevated liver enzyme and low platelet count. Your bp can remain normal with HELLP
syndrome.
4. What are the common medications used to treat preeclampsia and what risks do they carry?
Labetalol - it slows down the heart rates, making it easier for the heart to pump blood around
the body and can not be discontinued abruptly.
Magnesium sulfate – prevents seizures. Can cause breathing difficulties and lower bp
Methyldopa – headaches vomiting edma.
5. What is the nursing management for each?
Methyldopa – Monitor VS, Is/Os, monitor for hypotension.
Labetalol- monitor Bp, educate pt about not standing up to quickly, the nurse should take the
blood pressure immediately before the administration.
Magnesium sulfate – Test reflexs, Monitor magnesium levels, and encourage fluids.
6. What assessments need to be conducted frequently for the patient with preeclampsia?
Weighing the patient regularly, check for edma, monitor Is and Os, checking lung sound,
monitoring vitals, LOC, deep tendon reflex, and urinalysis.
7. Describe deep tendon reflexes and how they are graded.
Grade 0 = No Resonse
Grade 1+ = Diminished/depressed response
Grade 2+ = Active normal response
Grade 3 = Brisk/exaggerated response
Grade 4+ = Very brisk/hyperactive; abnormal response
8. Discuss why a patient with preeclampsia is at risk for seizures. What are seizure precautions and
how are they instituted?
When arteries are damaged, there is a restriction in the blood flow. It can produce swelling in
the blood vessels in the patient's brain and in the growing baby. If this abnormal blood flow
through vessels hinders the brain's ability to function, seizures may occur.
9. Describe the nursing care involved with seizure activity.
Note when the seizure began, turn pt to side, maintain patent air way, pad bed rails, and
monitor the fetus.
10. What are the signs of magnesium toxicity in the mother and the baby?
The most common signs of developing magnesium toxicity include respiratory depression,
nausea, muscle weakness, loss of reflexes, and decrease in BP or pulse. Also low urine output.
11. What are the risks to the mother and fetus in states of hypertension or magnesium sulfate
toxicity?
abruptio placenta, preterm birth/premature delivery, and pregnancy loss or stillbirth.
12. What is the definitive treatment and why?
The definitive treatment of preeclampsia/eclampsia is delivery of the fetus. This is to prevent
the development of maternal or fetal complications from disease progression. Delivery leads to
the ultimate resolution of the disease.
13. Identify the common lab tests indicated for the patient with preeclampsia and discuss the cause
of abnormal findings. In addition, describe L/S ratio and phosphatidylglycerol and identify why
these tests are important prior to delivery of the baby.
Urine analysis. measurement of the amount of protein in the urine.
Uric acid. Increased uric acid in the blood is often the earliest laboratory finding related to
preeclampsia.
Hematocrit. A high hematocrit value can be a sign of preeclampsia.
The focus of testing the L/S ratio is to determine fetal lung maturity to decrease the risk of
delivering a neonate with respiratory distress syndrome. Amniotic fluid phosphatidylglycerol is
an early indicator of fetal lung maturity.