👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Physiological Adaptation🔖 Free to read, print, and share
Also known as: PIH · preeclampsia · eclampsia · toxemia · high blood pressure in pregnancy · HELLP
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Use this quick-reference guide to spot, treat, and prevent Pregnancy-Induced Hypertension on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
🩺 Signs
HTN, proteinuria, edema
Headache, blurred vision
Epigastric pain, ↑ DTRs
🧪 Meds
Mag sulfate → seizure prevent
Therapeutic Mg 4–7 mEq/L
Antidote = Ca gluconate
🚩 Report
↓ RR < 12, absent DTRs
↓ UO < 30 mL/hr = Mg toxic
Seizure = eclampsia, ABCs
✅ Do
Quiet, dim room, seizure precaut
Delivery = only cure
📚 Pregnancy-Induced Hypertension — 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.
Pregnancy-induced hypertension is new-onset high blood pressure after 20 weeks gestation, spanning gestational hypertension, preeclampsia (hypertension plus proteinuria or organ involvement), and eclampsia (seizures). The underlying problem is vasospasm and poor placental perfusion. The only cure is delivery; the priority is preventing seizures and stroke.
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Key points
Understand these first
Diagnosis requires BP at or above 140/90 on two occasions after 20 weeks; severe features include BP at or above 160/110.
Preeclampsia adds proteinuria, or in its absence, signs like thrombocytopenia, elevated liver enzymes, renal insufficiency, pulmonary edema, or visual/cerebral symptoms.
Severe-feature warning signs include headache, visual changes, epigastric or right upper quadrant pain, and hyperreflexia with clonus.
HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) is a dangerous variant.
Magnesium sulfate is the drug of choice to prevent and treat seizures, not to lower blood pressure.
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Nursing priorities
What to do, in order
Monitor blood pressure, deep tendon reflexes, urine output, and for headache, visual changes, and epigastric pain.
Administer magnesium sulfate as ordered and monitor closely for toxicity (loss of reflexes, respiratory depression, decreased urine).
Keep calcium gluconate at the bedside as the antidote for magnesium toxicity.
Maintain a quiet, low-stimulation environment with seizure precautions and side rails padded.
Give antihypertensives such as labetalol or hydralazine for severe-range blood pressure.
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Red flags — report now
Escalate immediately
Loss of deep tendon reflexes, respiratory rate under 12, or urine output under 30 mL/hr indicates magnesium toxicity; stop the infusion and give calcium gluconate.
Seizure activity signals eclampsia, an obstetric emergency; protect the airway and call for help.
Severe headache, blurred vision, or epigastric pain warns of impending seizure or hepatic involvement and must be reported immediately.
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Labs & values
Numbers to know
Platelets: 150,000 to 400,000; below 100,000 suggests severe disease or HELLP
AST/ALT: elevated liver enzymes indicate HELLP or severe preeclampsia
Urine protein: proteinuria (1+ or greater, or 300 mg per 24 hours) supports preeclampsia
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Patient teaching
What patients must know
Report headaches, vision changes, swelling of the face or hands, or upper belly pain right away.
Rest on your left side to improve blood flow to the baby.
Keep all prenatal appointments for blood pressure and urine checks; this condition can worsen quickly.
❓ Pregnancy-Induced Hypertension: NCLEX FAQs
What are the priority nursing interventions for Pregnancy-Induced Hypertension?
Monitor blood pressure, deep tendon reflexes, urine output, and for headache, visual changes, and epigastric pain. Administer magnesium sulfate as ordered and monitor closely for toxicity (loss of reflexes, respiratory depression, decreased urine). Keep calcium gluconate at the bedside as the antidote for magnesium toxicity. Maintain a quiet, low-stimulation environment with seizure precautions and side rails padded.
What are the warning signs of Pregnancy-Induced Hypertension a nurse must report?
Loss of deep tendon reflexes, respiratory rate under 12, or urine output under 30 mL/hr indicates magnesium toxicity; stop the infusion and give calcium gluconate. Seizure activity signals eclampsia, an obstetric emergency; protect the airway and call for help. Severe headache, blurred vision, or epigastric pain warns of impending seizure or hepatic involvement and must be reported immediately.
What do I need to know about Pregnancy-Induced Hypertension for the NCLEX?
Diagnosis requires BP at or above 140/90 on two occasions after 20 weeks; severe features include BP at or above 160/110. Preeclampsia adds proteinuria, or in its absence, signs like thrombocytopenia, elevated liver enzymes, renal insufficiency, pulmonary edema, or visual/cerebral symptoms. Severe-feature warning signs include headache, visual changes, epigastric or right upper quadrant pain, and hyperreflexia with clonus. HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) is a dangerous variant.
What patient teaching is important for Pregnancy-Induced Hypertension?
Report headaches, vision changes, swelling of the face or hands, or upper belly pain right away. Rest on your left side to improve blood flow to the baby. Keep all prenatal appointments for blood pressure and urine checks; this condition can worsen quickly.
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Quick Tip
Diagnosis requires BP at or above 140/90 on two occasions after 20 weeks; severe features include BP at or above 160/110.