👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Physiological Adaptation🔖 Free to read, print, and share
Also known as: pregnancy seizures · seizures in pregnancy · toxemia seizures · preeclampsia with seizures
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Use this quick-reference guide to spot, treat, and prevent Eclampsia on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Define
Tonic-clonic seizures + preeclampsia
Obstetric emergency
✅ Do First
Airway first → turn side, O2
Stay, protect from injury, call help
Don't restrain or insert anything
🧪 Meds
Mag sulfate = drug of choice
Antidote: calcium gluconate ready
✅ After
Assess fetus, prepare delivery
📚 Eclampsia — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Eclampsia is the onset of generalized tonic-clonic seizures in a woman with preeclampsia, with no other cause for the seizures. It results from severe cerebral vasospasm, edema, and hypertension. It is an obstetric emergency that threatens both maternal airway/oxygenation and fetal oxygenation. The priority during a seizure is patient safety and airway, not stopping the seizure with force.
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Key points
Understand these first
Seizures are typically generalized tonic-clonic and may be preceded by a severe headache, visual changes, and hyperreflexia with clonus.
Cerebral vasospasm and edema cause the seizure activity.
During the seizure the mother becomes apneic, risking maternal and fetal hypoxia.
A transient fetal bradycardia commonly follows the maternal seizure as placental perfusion drops.
Seizures can occur before, during, or up to 48-72 hours after delivery (postpartum eclampsia).
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Nursing priorities
What to do, in order
Protect the airway: turn the patient to the side, do not restrain, and do not insert objects into the mouth.
Apply oxygen by face mask and have suction ready for secretions after the seizure ends.
Administer or continue magnesium sulfate as the first-line drug to control and prevent further seizures.
After the seizure, assess fetal heart rate and uterine activity and notify the provider immediately.
Keep the room quiet and dim and pad the side rails to reduce stimulation and injury risk.
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Red flags — report now
Escalate immediately
A seizure in a pregnant or recently delivered woman is an emergency; call for help and notify the provider at once.
Report persistent fetal bradycardia or late decelerations after the seizure, which signal fetal compromise.
Watch for signs of magnesium toxicity (absent reflexes, respirations under 12, low urine output) and have calcium gluconate available as the antidote.
Never leave the patient unattended during or immediately after a seizure.
Postpartum patients should report headaches, visual changes, or feeling like they may pass out, since seizures can occur after delivery.
Have a support person stay with the patient during the high-risk period.
❓ Eclampsia: NCLEX FAQs
What are the priority nursing interventions for Eclampsia?
Protect the airway: turn the patient to the side, do not restrain, and do not insert objects into the mouth. Apply oxygen by face mask and have suction ready for secretions after the seizure ends. Administer or continue magnesium sulfate as the first-line drug to control and prevent further seizures. After the seizure, assess fetal heart rate and uterine activity and notify the provider immediately.
What are the warning signs of Eclampsia a nurse must report?
A seizure in a pregnant or recently delivered woman is an emergency; call for help and notify the provider at once. Report persistent fetal bradycardia or late decelerations after the seizure, which signal fetal compromise. Watch for signs of magnesium toxicity (absent reflexes, respirations under 12, low urine output) and have calcium gluconate available as the antidote. Never leave the patient unattended during or immediately after a seizure.
What do I need to know about Eclampsia for the NCLEX?
Seizures are typically generalized tonic-clonic and may be preceded by a severe headache, visual changes, and hyperreflexia with clonus. Cerebral vasospasm and edema cause the seizure activity. During the seizure the mother becomes apneic, risking maternal and fetal hypoxia. A transient fetal bradycardia commonly follows the maternal seizure as placental perfusion drops.
What patient teaching is important for Eclampsia?
Postpartum patients should report headaches, visual changes, or feeling like they may pass out, since seizures can occur after delivery. Have a support person stay with the patient during the high-risk period.
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Quick Tip
Seizures are typically generalized tonic-clonic and may be preceded by a severe headache, visual changes, and hyperreflexia with clonus.