👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Physiological Adaptation🔖 Free to read, print, and share
Also known as: high blood pressure in pregnancy · pregnancy high BP · toxemia · PIH · pregnancy-induced hypertension
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Use this quick-reference guide to spot, treat, and prevent Preeclampsia on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
🩺 Signs
BP ≥ 140/90 after 20 wks
Proteinuria, edema (face/hands)
📌 Severe
Headache, blurred vision, RUQ pain
Hyperreflexia, clonus → seizure risk
HELLP: hemolysis, ↑ LFTs, ↓ platelets
✅ Do
Mag sulfate to prevent seizures
Quiet dim room, seizure precautions
📌 Cure
Delivery = only cure
📚 Preeclampsia — 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.
Preeclampsia is a pregnancy-specific multisystem disorder of new-onset hypertension (BP 140/90 or higher after 20 weeks gestation) plus proteinuria or signs of end-organ damage. It is caused by abnormal placental development leading to vasospasm, endothelial damage, and reduced organ perfusion. It matters because untreated it can progress to eclampsia (seizures), HELLP syndrome, and fetal compromise. Classic triad memory aid: hypertension, proteinuria, edema.
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Key points
Understand these first
New-onset BP at or above 140/90 on two readings after 20 weeks gestation defines the hypertension component.
Proteinuria (300 mg or more in 24 hours, or protein/creatinine ratio elevation) reflects glomerular damage.
Generalized vasospasm reduces perfusion to the brain, liver, kidneys, and placenta.
Severe-feature signs include headache, visual changes (blurring, spots, scotomata), and epigastric or right upper quadrant pain from hepatic capsule stretch.
Hyperreflexia and clonus indicate central nervous system irritability and rising seizure risk.
Sudden facial and hand edema with rapid weight gain reflects third-spacing of fluid.
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Nursing priorities
What to do, in order
Monitor blood pressure frequently and assess deep tendon reflexes and clonus each shift.
Place the patient on the left lateral side to maximize uteroplacental perfusion.
Administer prescribed antihypertensives (labetalol, hydralazine, nifedipine) to keep BP controlled but not hypotensive.
Initiate magnesium sulfate as ordered for seizure prophylaxis in severe features and keep the environment quiet and low-stimulus.
Maintain seizure precautions and have oxygen, suction, and emergency medications at the bedside.
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Red flags — report now
Escalate immediately
Report severe headache, visual disturbances, or epigastric/right upper quadrant pain as these signal impending eclampsia.
Report oliguria (urine output under 30 mL/hr), which indicates worsening renal perfusion.
Report a sudden drop in platelets, rising liver enzymes, or hemolysis, which suggest HELLP syndrome.
Definitive cure is delivery of the placenta; escalate immediately if seizures, severe BP, or fetal distress occur.
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Labs & values
Numbers to know
Platelets: normal 150,000-400,000/mcL (thrombocytopenia under 100,000 is a severe feature)
AST/ALT: normal roughly 10-40 units/L (elevated in HELLP)
24-hour urine protein: normal under 300 mg/24 hr (300 mg or more is abnormal)
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Patient teaching
What patients must know
Report headaches, visual changes, or upper abdominal pain immediately rather than waiting for an appointment.
Keep all prenatal visits for blood pressure, weight, and urine monitoring.
Rest on the left side and follow activity restrictions prescribed by the provider.
❓ Preeclampsia: NCLEX FAQs
What are the priority nursing interventions for Preeclampsia?
Monitor blood pressure frequently and assess deep tendon reflexes and clonus each shift. Place the patient on the left lateral side to maximize uteroplacental perfusion. Administer prescribed antihypertensives (labetalol, hydralazine, nifedipine) to keep BP controlled but not hypotensive. Initiate magnesium sulfate as ordered for seizure prophylaxis in severe features and keep the environment quiet and low-stimulus.
What are the warning signs of Preeclampsia a nurse must report?
Report severe headache, visual disturbances, or epigastric/right upper quadrant pain as these signal impending eclampsia. Report oliguria (urine output under 30 mL/hr), which indicates worsening renal perfusion. Report a sudden drop in platelets, rising liver enzymes, or hemolysis, which suggest HELLP syndrome. Definitive cure is delivery of the placenta; escalate immediately if seizures, severe BP, or fetal distress occur.
What do I need to know about Preeclampsia for the NCLEX?
New-onset BP at or above 140/90 on two readings after 20 weeks gestation defines the hypertension component. Proteinuria (300 mg or more in 24 hours, or protein/creatinine ratio elevation) reflects glomerular damage. Generalized vasospasm reduces perfusion to the brain, liver, kidneys, and placenta. Severe-feature signs include headache, visual changes (blurring, spots, scotomata), and epigastric or right upper quadrant pain from hepatic capsule stretch.
What patient teaching is important for Preeclampsia?
Report headaches, visual changes, or upper abdominal pain immediately rather than waiting for an appointment. Keep all prenatal visits for blood pressure, weight, and urine monitoring. Rest on the left side and follow activity restrictions prescribed by the provider.
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Quick Tip
New-onset BP at or above 140/90 on two readings after 20 weeks gestation defines the hypertension component.