Essential Guide: 2025 Preeclampsia Nursing Care Plan, Diagnosis, and Interventions

What Is Preeclampsia? Understanding the Condition in 2025

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Preeclampsia is a life-threatening pregnancy complication that demands swift, evidence-based nursing care. Far beyond simply elevated blood pressure, preeclampsia involves a complex mix of symptoms that can endanger both the mother and fetus if left unmanaged. Developing a comprehensive nursing care plan for preeclampsia, including accurate nursing diagnoses and timely interventions, is critical to improving patient outcomes and preventing serious complications such as eclampsia, HELLP syndrome, or preterm birth.

Contents hide

1 What Is Preeclampsia?

2 Definition and Overview

3 Pathophysiology of Preeclampsia

4 Difference Between Gestational Hypertension and Preeclampsia

5 Causes of Preeclampsia (Related To)

6 Signs and Symptoms of Preeclampsia (As Evidenced By)

7 Risk Factors for Preeclampsia

8 Nursing Assessment for Preeclampsia

9 Subjective Data: Patient-Reported Symptoms

10 Nursing Diagnoses for Preeclampsia

11 Expected Outcomes and Nursing Goals

12 Nursing Interventions for Preeclampsia

13 Monitor and Manage Hypertension

14 Administer Antihypertensive Medications

15 Prevent Seizures and Complications

16 Monitor for Signs of Eclampsia

17 Key Signs and Symptoms of Impending Eclampsia

18 Ensure Fetal Well-being

19 Educate the Patient

20 Emergency Management of Eclampsia

21 3. Notify the Health Care Provider (HCP)

22 Patient Education for Emergency Management

23 Preeclampsia Nursing Care Plan Example

24 Care Plan #2: Preeclampsia with Risk for Eclampsia

25 Care Plan #3: Preeclampsia with Risk for Fetal Complications

26 Prevention of Preeclampsia and Long-Term Management

27 References and Sources

Preeclampsia

By understanding the key aspects of preeclampsia—its causes, signs, and pathophysiology—nurses can play a vital role in early detection and intervention. This guide offers essential tools for managing preeclampsia in 2025, with up-to-date nursing diagnoses, step-by-step care plans, and real-world interventions tailored to support maternal and fetal health.

What Is Preeclampsia?

Proper recognition and management of preeclampsia start with a clear understanding of the condition. For nurses, developing an accurate nursing care plan for preeclampsia is essential for guiding clinical decisions and delivering effective, patient-centered care.

Definition and Overview

Preeclampsia is a pregnancy-related hypertensive disorder marked by elevated blood pressure (≥140/90 mmHg) and proteinuria occurring after 20 weeks of gestation. It is a complex, multisystem condition that affects the cardiovascular, renal, hepatic, and central nervous systems, potentially leading to serious or even life-threatening complications for both mother and baby.

Pathophysiology of Preeclampsia

Understanding the pathophysiology of preeclampsia helps nurses anticipate complications and respond appropriately:

Abnormal placental development: Reduced placental blood flow leads to hypoxia and triggers the release of anti-angiogenic substances that damage blood vessel linings.
Endothelial dysfunction: Causes increased vascular permeability, resulting in hypertension, proteinuria, and edema.
Vasospasm and clotting disturbances: Impair organ perfusion and can injure critical organs such as the kidneys, liver, and brain.

Difference Between Gestational Hypertension and Preeclampsia

Understanding the distinction between gestational hypertension and preeclampsia is key to accurate diagnosis:

Gestational Hypertension:

Elevated blood pressure (≥140/90 mmHg) without proteinuria after 20 weeks of pregnancy.
Usually resolves within 12 weeks postpartum.

Preeclampsia:

High blood pressure with proteinuria or signs of end-organ dysfunction.
Can progress to more severe conditions such as eclampsia (seizures) or HELLP syndrome (Hemolysis, Elevated Liver Enzymes, and Low Platelet count).

Causes of Preeclampsia (Related To)

Understanding what causes preeclampsia is vital to building an accurate nursing diagnosis and developing effective, evidence-based interventions. These underlying contributors explain why the condition occurs and help guide clinical decisions.

Placental Abnormalities

Inadequate placental development: Poor trophoblastic invasion and abnormal remodeling of spiral arteries reduce placental blood flow.
Placental ischemia: Decreased perfusion leads to systemic vascular dysfunction and hypertension.

Maternal Risk Factors

Obesity and diabetes: Insulin resistance and systemic inflammation increase the risk of preeclampsia.
Chronic hypertension: Women with a history of high blood pressure are more likely to develop superimposed preeclampsia.
Pre-existing kidney disease: Impaired renal filtration may worsen proteinuria and fluid imbalance.

Genetic and Environmental Influences

Family history: A maternal or paternal lineage with a history of preeclampsia increases a woman’s risk.
Lifestyle and prenatal care: Poor nutrition, high stress levels, and limited access to prenatal care are common contributing factors.

Preeclampsia

Signs and Symptoms of Preeclampsia (As Evidenced By)

Recognizing the early signs and symptoms of preeclampsia is critical in preventing complications. These clinical manifestations form the basis for nursing assessment and intervention planning.

High Blood Pressure (≥140/90 mmHg)

Severe cases may present with BP readings ≥160/110 mmHg on two occasions at least four hours apart.

Proteinuria (Protein in the Urine)

Dipstick testing shows ≥1+ protein on two separate readings.
24-hour urine collection indicates ≥300 mg of protein.

Neurological Symptoms

Persistent, severe headaches unrelieved by standard analgesics.
Visual disturbances: Blurred vision, light sensitivity, and visual spots (scotomata).

Edema and Rapid Weight Gain

Facial and hand swelling due to fluid retention.
Sudden weight gain, often >5 pounds in a week, is an early warning sign.

Epigastric Pain, Nausea, and Vomiting

Right upper quadrant pain from liver distension or hematoma formation.
Nausea and vomiting typically signal severe preeclampsia or impending HELLP syndrome.

Risk Factors for Preeclampsia

Awareness of risk factors for preeclampsia helps in early detection and preventative care:

First-time pregnancy (primigravida) or multiple gestations (twins or more).
Maternal age under 20 or over 35 years.
Pre-existing hypertension, renal disease, or autoimmune disorders (e.g., lupus).
Family history of preeclampsia or maternal complications.
Assisted reproductive technologies (e.g., IVF), which may affect placental implantation.

Nursing Assessment for Preeclampsia

A thorough nursing assessment for preeclampsia provides essential data for diagnosis and treatment planning. Both objective findings and subjective reports are necessary for complete clinical evaluation.

Objective Data

Blood Pressure Monitoring
- Take BP readings in a seated position, with the arm supported at heart level.
- Confirm elevated readings on two separate occasions at least four hours apart.
Laboratory Tests
- Urinalysis: To detect proteinuria.
- Liver function tests: Elevated AST and ALT levels suggest hepatic involvement.
- Platelet count: Thrombocytopenia (<100,000/mm³) indicates possible HELLP syndrome.
- Serum creatinine: Elevated levels point to renal impairment.
- Coagulation profile: Essential to evaluate clotting issues and diagnose HELLP.

Preeclampsia

Subjective Data: Patient-Reported Symptoms

Subjective findings offer valuable insight into the progression and severity of preeclampsia. Listening carefully to the patient’s complaints can help guide a more accurate nursing diagnosis and timely interventions.

Common Patient Complaints:

Severe headache: Persistent and not relieved by over-the-counter pain medications.
Visual disturbances: Blurred vision, double vision, or reports of seeing flashing lights or spots.
Swelling and rapid weight gain: Notably in the hands, face, and feet, often sudden in onset.
Epigastric pain and nausea: Typically located in the right upper quadrant and associated with hepatic involvement.

Nursing Diagnoses for Preeclampsia

Establishing the correct nursing diagnosis for preeclampsia is essential to formulating a safe, targeted care plan. Below are the top-priority nursing diagnoses that support both maternal and fetal outcomes:

1. Risk for Imbalanced Fluid Volume

Related to: Elevated blood pressure and increased vascular permeability.
As evidenced by: Generalized edema, proteinuria, and unexplained rapid weight gain.

2. Risk for Unstable Blood Pressure

Related to: Systemic vasoconstriction and endothelial dysfunction.
As evidenced by: Sustained hypertension (BP ≥140/90 mmHg), with potential spikes in severe cases.

3. Deficient Knowledge Regarding Preeclampsia Management

Related to: Limited understanding of the disease process, treatment plan, and potential complications.
As evidenced by: Patient anxiety, frequent questions, and inconsistent adherence to lifestyle modifications or medication.

4. Risk for Fetal Injury

Related to: Decreased uteroplacental perfusion caused by placental insufficiency.
As evidenced by: Abnormal fetal heart rate patterns, reduced fetal movement, or signs of intrauterine growth restriction (IUGR).

https://www.realnursingjourney.com/preeclampsia-nursing-care-plan-2025

Expected Outcomes and Nursing Goals

After identifying key nursing diagnoses, the next step is to establish realistic goals and expected outcomes. These outcomes help track the patient’s progress and prevent the condition from worsening.

Maintain Blood Pressure Within Target Range

Mild preeclampsia: Maintain BP below 140/90 mmHg through lifestyle modifications and close monitoring.
Severe preeclampsia: Control BP to below 160/110 mmHg with antihypertensive medications as prescribed.

Prevent Maternal and Fetal Complications

Avoid escalation to eclampsia or HELLP syndrome.
Monitor for signs of disseminated intravascular coagulation (DIC).
Proactively manage lab abnormalities and neurological symptoms.

Promote Fetal Well-being

Conduct ongoing fetal heart rate monitoring.
Utilize biophysical profiles (BBPs) and Doppler ultrasounds to assess placental blood flow.

Enhance Patient Education and Engagement

Educate on early warning signs such as headaches, visual disturbances, and right upper quadrant pain.
Stress the importance of medication adherence and lifestyle modifications.
Encourage consistent prenatal visits and follow-ups to track both maternal and fetal health.

Nursing Interventions for Preeclampsia

Nursing interventions for preeclampsia are designed to manage hypertension, prevent complications such as seizures or HELLP syndrome, ensure fetal well-being, and provide patient education. These actions are vital in preventing the progression of preeclampsia and promoting safe outcomes for both mother and baby.

Monitor and Manage Hypertension

Purpose: To identify worsening hypertension early and prevent serious complications such as placental abruption, stroke, or eclampsia.

Frequency of Blood Pressure (BP) Monitoring:

Severe preeclampsia: Every 15–30 minutes
Mild to moderate preeclampsia: Every 4–6 hours
Continuous monitoring: When patient is on IV magnesium sulfate or antihypertensives

Technique:

Use a consistent arm and cuff size for accuracy.
Position patient seated, arm at heart level.
Allow a minimum of 5 minutes of rest before measurement.

Target BP Goals:

Mild preeclampsia: < 140/90 mmHg
Severe preeclampsia: < 160/110 mmHg, but not < 90/60 mmHg to preserve placental perfusion

Nursing Actions:

Accurately record BP values, including time and position.
Observe for associated symptoms: headache, blurred vision, and upper abdominal pain.
Immediately report sustained BP > 160/110 mmHg to the healthcare provider.
https://www.realnursingjourney.com/preeclampsia-nursing-care-plan-2025

Administer Antihypertensive Medications

Purpose: To safely reduce blood pressure and prevent complications like intracranial hemorrhage or placental detachment.

Common Antihypertensive Medications for Preeclampsia:

Labetalol (IV):
- Dose: 20 mg initially, followed by 40–80 mg every 10 minutes as needed (max 300 mg)
- Contraindicated in asthma, heart failure, bradycardia
Hydralazine (IV):
- Dose: 5–10 mg every 20 minutes
- Watch for: Headache, flushing, tachycardia
Nifedipine (oral):
- Dose: 10–20 mg every 4–6 hours
- Side effects: Reflex tachycardia, hypotension

Nursing Actions:

Monitor BP and pulse before and after each dose.
Educate the patient on purpose and possible side effects.
Adjust dosages in collaboration with the provider based on patient response.

Prevent Seizures and Complications

1. Administer Magnesium Sulfate

Purpose: To prevent seizures in patients with preeclampsia and treat seizures in cases of eclampsia.

Mechanism of Action:

Acts as a central nervous system depressant
Reduces cerebral edema
Stabilizes neural activity

Dosage:

Loading dose: 4–6 grams IV over 15–30 minutes
Maintenance dose: 1–2 grams/hour IV infusion
Duration: Continue for 24 hours postpartum or until stable

Therapeutic Range: 4–7 mEq/L
Signs of Toxicity:

Respiratory rate < 12 breaths/min
Urine output < 30 mL/hour
Loss of deep tendon reflexes
Lethargy or cardiac arrhythmias

2. Monitor for Magnesium Toxicity

Essential Monitoring Parameters:

Deep Tendon Reflexes (DTRs): Check every 1–2 hours; diminished reflexes may signal toxicity
Respiratory Rate: Monitor hourly; report if < 12/min
Urine Output: Ensure ≥ 30 mL/hr to allow drug clearance
Level of Consciousness: Assess for confusion or drowsiness
Cardiac Monitoring: Use ECG to watch for arrhythmias in high-risk patients

3. Antidote and Emergency Measures

Calcium Gluconate is the antidote for magnesium sulfate toxicity.

Dose: 1 gram IV over 3 minutes
Note: Always keep calcium gluconate available at bedside when administering magnesium sulfate.

Monitor for Signs of Eclampsia

Eclampsia is the onset of seizures in a patient with preeclampsia and is considered a medical emergency.

Warning Signs to Watch For:

Severe persistent headache
Blurred vision or visual scotomata
Hyperreflexia or clonus
Sudden elevation in BP
Epigastric pain or right upper quadrant pain

Key Signs and Symptoms of Impending Eclampsia

Recognizing impending eclampsia is critical for early intervention and the prevention of maternal and fetal complications. Nurses must stay vigilant for the following warning signs in patients with severe preeclampsia:

Severe, Persistent Headache
Unrelieved by medication and often described as throbbing or pulsating in nature.
Visual Disturbances
Includes blurred vision, photophobia (light sensitivity), and scotomata (flashing lights or visual spots).
Epigastric or Right Upper Quadrant Pain
Often described as sharp, radiating pain due to hepatic involvement or subcapsular hematoma.
Nausea and Vomiting
Associated with liver dysfunction or increased intracranial pressure.
Altered Mental Status
Signs include restlessness, irritability, confusion, and decreased level of consciousness.
Hyperreflexia and Clonus
Hyperactive deep tendon reflexes (DTRs) rated 3+ or 4+ and presence of ankle clonus (rhythmic contractions upon dorsiflexion) are common signs of worsening preeclampsia.

Ensure Fetal Well-being

Continuous fetal monitoring is essential in preeclampsia to assess the baby’s oxygenation and detect early signs of distress due to placental insufficiency.

1. Fetal Heart Rate Monitoring (FHR)

Purpose: To monitor for signs of fetal hypoxia or compromise related to decreased placental perfusion in preeclampsia.

Monitoring Frequency:

Severe preeclampsia: Continuous electronic fetal monitoring (EFM)
Mild preeclampsia: Every 4 hours

Expected Findings:

Normal FHR: 110–160 bpm
Moderate variability = Reassuring sign
Abnormal: Late decelerations, decreased variability, bradycardia

Nursing Actions:

Document and report abnormal FHR patterns immediately.
Position the patient in the left lateral position to improve uteroplacental blood flow.
Ensure optimal hydration and oxygenation.

2. Biophysical Profile (BPP) and Doppler Studies

These non-invasive tools assess fetal health and placental circulation in pregnancies complicated by preeclampsia.

Biophysical Profile (BPP):

Combines ultrasound and non-stress test (NST)
Evaluates fetal movement, tone, breathing, amniotic fluid volume, and FHR
Normal Score: 8–10
Abnormal Score: < 6 may indicate fetal compromise

Doppler Studies:

Assess umbilical artery blood flow resistance.
Increased resistance suggests placental insufficiency and fetal risk.

Nursing Actions:

Educate the patient on the purpose and process of BPP and Doppler tests.
Assist with scheduling and preparation for ultrasound procedures.
Report abnormal test results to the healthcare provider promptly.

Educate the Patient

Patient education is a cornerstone of effective preeclampsia management, empowering expectant mothers to participate in their care and recognize signs of deterioration.

1. Lifestyle Modifications

Bed Rest: Encourage partial bed rest in a lateral position to promote placental perfusion. Avoid complete immobility to reduce risk of thromboembolism.
Dietary Education:
- Low-sodium diet to help manage hypertension
- High-protein intake to counter protein loss through urine
Hydration: Encourage adequate fluid intake unless contraindicated by renal impairment.

2. Recognizing Emergency Symptoms

Teach patients the early warning signs that require immediate medical attention:

Severe headache unrelieved by analgesics
Visual disturbances (flashing lights, blurred vision)
Epigastric or RUQ pain
Nausea, vomiting, or dizziness
Sudden shortness of breath
Decreased fetal movements

Emergency Management of Eclampsia

Eclampsia is a life-threatening progression of preeclampsia involving seizure activity. Prompt, effective action can reduce the risk of maternal or fetal morbidity.

1. During a Seizure (Tonic-Clonic Activity)

Nursing Actions:

Positioning: Turn patient to the left side to maintain airway and prevent aspiration.
Airway and Oxygenation: Clear airway; administer oxygen at 8–10 L/min via face mask.
Safety Measures:
- Do not restrain the patient
- Pad side rails and protect the patient’s head from trauma

2. Post-Seizure (Postictal Phase)

Nursing Actions:

Maintain airway patency and continue oxygen therapy.
Suction secretions to prevent aspiration.
Monitor vital signs and neurologic status closely.
Assess level of consciousness and mental status.

Medication:

Administer additional magnesium sulfate: 2g IV over 3–5 minutes if seizures recur.
Keep calcium gluconate readily available at bedside in case of magnesium toxicity.

3. Notify the Health Care Provider (HCP)

Timely communication with the health care provider is essential in managing complications from preeclampsia, especially during emergencies such as seizures or worsening maternal or fetal status.

Nursing Actions:

Immediately notify the HCP in the event of eclamptic seizures or signs of impending eclampsia.
Prepare the patient for emergency delivery if maternal or fetal condition is compromised.
Document all abnormal findings and interventions before and after the event.

Patient Education for Emergency Management

Empowering patients with the knowledge to recognize worsening symptoms of preeclampsia is key to early intervention and prevention of complications.

Teaching Points:

Seek immediate medical attention if experiencing:
- Severe, persistent headache
- Visual disturbances
- Epigastric or right upper quadrant pain
- Decreased fetal movement
Contact your healthcare provider if BP readings exceed 160/110 mmHg.
Reinforce the importance of medication adherence, scheduled prenatal visits, and monitoring for early warning signs.

Preeclampsia Nursing Care Plan Example

A detailed care plan supports individualized care and improves outcomes in patients with preeclampsia. Below is a sample focused on a patient presenting with severe preeclampsia and hypertension.

Care Plan #1: Severe Preeclampsia with Hypertension

Nursing Diagnosis:
Risk for Unstable Blood Pressure

Related To:

Increased vascular resistance from endothelial dysfunction
Placental insufficiency leading to vasoconstrictive substance release
Impaired autoregulation of BP due to severe preeclampsia

As Evidenced By:

BP readings > 160/110 mmHg on two occasions, four hours apart
Severe, unrelieved headache
Visual changes (e.g., blurred vision, scotomata)
Epigastric or RUQ pain

Expected Outcomes

Short-Term Goals:

Maintain systolic BP < 160 and diastolic < 110 mmHg within 24 hours
Prevent seizure activity or progression to HELLP syndrome
Alleviate headache and visual disturbances within 24 hours

Long-Term Goals:

Stabilize BP within normal range (< 140/90 mmHg) prior to discharge
Prevent long-term complications (e.g., kidney damage, heart disease)
Educate patient on lifestyle changes and compliance with medications

Nursing Assessment

Objective Data:

BP Monitoring: Every 15–30 minutes for severe hypertension
Continuous monitoring if on IV antihypertensives or magnesium sulfate
Lab Results:
- Liver function: ↑ AST and ALT
- Platelets: ↓ (< 100,000/mm³)
- Creatinine: Elevated levels indicate renal involvement
Neurological Assessment: Monitor for altered LOC, DTRs, headache

Subjective Data:

Patient reports persistent headache unrelieved by analgesics
Describes visual disturbances: seeing spots, blurred vision
Complains of RUQ/epigastric pain and light sensitivity

Nursing Interventions

1. Frequent Blood Pressure Monitoring

Check BP every 15–30 minutes until stable
Use same arm and positioning to ensure consistency
Document readings with time and patient position

2. Administer Antihypertensive Medications

Labetalol: 20 mg IV bolus; may repeat with 40–80 mg every 10 minutes (max 300 mg)
Hydralazine: 5–10 mg IV every 20 minutes as needed
Nifedipine: 10–20 mg PO every 4–6 hours for ongoing management
Monitor for adverse reactions (e.g., hypotension, headache)

3. Neurological Monitoring

Assess deep tendon reflexes (DTRs) every 1–2 hours
Check for hyperreflexia or clonus (CNS irritability)
Monitor for magnesium sulfate toxicity if applicable

4. Seizure Precautions and Safety Measures

Maintain a quiet, dim environment
Pad side rails and keep bed in the lowest position
Keep oxygen and suction readily available at the bedside

Care Plan #2: Preeclampsia with Risk for Eclampsia

Nursing Diagnosis:
Risk for Seizures

Related To:

Central nervous system (CNS) irritability caused by cerebral edema and vasospasm
Severe hypertension and endothelial dysfunction
Electrolyte imbalances increasing neuromuscular excitability

As Evidenced By:

Persistent severe headache and visual disturbances
Hyperreflexia and presence of clonus
Epigastric pain, nausea, and vomiting

Expected Outcomes

Short-Term Goals:

Prevent seizure onset during hospitalization
Maintain therapeutic magnesium sulfate levels between 4–7 mEq/L
Relieve neurologic symptoms such as headache and visual changes

Long-Term Goals:

Prevent progression of preeclampsia to eclampsia or other neurologic complications
Educate the patient and family about early warning signs of seizures
Ensure a safe delivery and smooth postpartum recovery

Nursing Assessment

Neurological Monitoring:

Deep tendon reflexes (DTRs): Check every 1–2 hours for hyperreflexia or clonus
Mental status: Monitor for restlessness, confusion, agitation, or changes in level of consciousness
Visual symptoms: Assess for blurred vision, photophobia, or flashing lights (scotomata)

Laboratory Monitoring:

Serum magnesium levels: Every 4–6 hours to ensure within therapeutic range (4–7 mEq/L)
Electrolytes: Monitor sodium, potassium, and calcium for neuromuscular excitability

Nursing Interventions

1. Administer Magnesium Sulfate

Maintenance dose: 1–2 grams/hour IV infusion as prescribed
Toxicity Monitoring:
- DTRs: Watch for hyporeflexia or absent reflexes
- Respiratory rate: Report if <12 breaths/min
- Urine output: Maintain >30 mL/hour

2. Emergency Preparedness

Antidote on standby: Keep Calcium Gluconate (1 gram IV over 3 minutes) at the bedside
Suction and oxygen equipment: Ensure immediate availability
Seizure precautions: Padded side rails, low bed position, quiet environment

Care Plan #3: Preeclampsia with Risk for Fetal Complications

Nursing Diagnosis:
Risk for Fetal Injury

Related To:

Placental insufficiency caused by vasospasm and impaired endothelial function
Reduced uteroplacental perfusion leading to fetal hypoxia

As Evidenced By:

Abnormal fetal heart rate (FHR) patterns
Reduced fetal movement and intrauterine growth restriction (IUGR)
Biophysical profile or Doppler abnormalities

Expected Outcomes

Short-Term Goals:

Maintain FHR between 110–160 bpm with moderate variability
Detect signs of fetal distress early and initiate appropriate interventions

Long-Term Goals:

Achieve full-term or near-term delivery with minimal complications
Prevent adverse outcomes such as preterm birth, hypoxia, or stillbirth

Nursing Assessment

Fetal Monitoring:

Continuous electronic fetal monitoring (EFM) for patients with severe preeclampsia
Intermittent monitoring every 4 hours for mild or stable patients

Ultrasound-Based Assessments:

Biophysical Profile (BPP): Evaluate fetal breathing, movement, tone, amniotic fluid, and heart rate
Doppler studies: Measure umbilical artery blood flow for signs of placental insufficiency

Nursing Interventions

1. Continuous Fetal Monitoring

Document FHR patterns including baseline, variability, and decelerations
Report abnormal findings such as late decelerations, bradycardia, or reduced variability
Reposition the patient to left lateral position to improve placental blood flow

2. Schedule and Support Diagnostic Testing

Arrange BPP and Doppler evaluations as ordered
Educate the patient on the purpose and process of testing
Collaborate with the HCP to interpret and act on abnormal findings

3. Prepare for Emergency Delivery

Be ready for urgent cesarean section if persistent fetal distress occurs
Notify obstetric and neonatal teams for coordinated care in high-risk deliveries
Ensure all documentation and consents are in place for emergency intervention

Prevention of Preeclampsia and Long-Term Management

Preventing preeclampsia begins with early prenatal care but extends beyond pregnancy into postpartum recovery. A proactive, evidence-based approach to prevention, lifestyle modification, and long-term follow-up is essential to safeguard both maternal and fetal health.

Early Prenatal Care and Screening

Routine Prenatal Visits
Purpose: Early detection of preeclampsia symptoms and maintenance of maternal-fetal health.

Visit Frequency:

Every 4 weeks until 28 weeks gestation
Every 2 weeks from 28 to 36 weeks
Weekly from 36 weeks until delivery

Key Clinical Assessments:

Blood Pressure Monitoring: At every visit.
- Normal: < 140/90 mmHg
- Preeclampsia suspected: ≥ 140/90 mmHg on two separate readings, four hours apart
Weight Tracking: Sudden gain (>2 kg/week) may signal fluid retention
Urinalysis:
- Check for proteinuria with a dipstick
- Confirm with 24-hour urine collection if dipstick >1+
Blood Tests:
- Liver function (AST, ALT)
- Kidney function (serum creatinine, BUN)
- Platelet count to detect thrombocytopenia

Lifestyle Modifications to Reduce Preeclampsia Risk

1. Nutrition and Diet

Eat a balanced diet rich in vegetables, fruits, whole grains, and lean protein
Maintain adequate intake of calcium, potassium, and magnesium
Limit sodium intake to < 2,300 mg/day
Encourage hydration: 8–10 glasses of water per day

2. Weight Management

Target a healthy pre-pregnancy BMI (18.5–24.9)
Recommended gestational weight gain:
- Normal BMI: 25–35 lbs
- Overweight (BMI 25–29.9): 15–25 lbs
- Obese (BMI ≥30): 11–20 lbs

3. Physical Activity

At least 150 minutes/week of moderate-intensity aerobic exercise (e.g., walking, swimming)
Include gentle prenatal stretching or yoga
Avoid high-impact or supine exercises after 20 weeks gestation
Monitor for warning signs: vaginal bleeding, dizziness, or uterine contractions

4. Stress Reduction and Emotional Support

Teach deep breathing, guided meditation, or prenatal massage
Promote participation in support groups or prenatal classes
Conduct mental health screening to detect anxiety or depression

Postpartum Monitoring for Hypertension

Blood Pressure Surveillance

Purpose: To identify postpartum preeclampsia or persistent hypertension.

Frequency:

Daily monitoring for the first 72 hours postpartum
Weekly checks for six weeks if the patient had hypertensive disorders during pregnancy

Abnormal BP Values:

Postpartum hypertension: > 140/90 mmHg
Severe: ≥ 160/110 mmHg — requires immediate medical attention

Patient Education and Discharge Planning

Discharge teaching is a vital extension of the care plan. Providing patients with clear, actionable guidance helps prevent complications and encourages long-term wellness.

Home Blood Pressure Monitoring

Measure BP twice daily (morning and evening)
Rest quietly for at least 5 minutes before measuring
Document readings with time, date, and symptoms (if any)

Alert Thresholds:

Seek help if BP ≥ 160/110 mmHg
Report persistent symptoms like severe headache, blurred vision, or epigastric pain

Medication Adherence and Follow-Up Care

Emphasize the importance of taking antihypertensive medications as prescribed
Review side effects and actions for missed doses
Schedule routine postpartum visits with the OB/GYN and primary care provider
Monitor for long-term cardiovascular risks

Emergency Warning Signs of Worsening Preeclampsia

Educate patients and families to identify red flags that may indicate preeclampsia complications:

Call your provider or seek emergency care if you experience:

Severe headache not relieved by medication
Blurred vision, flashing lights, or visual changes
Sharp right upper quadrant or epigastric pain
Nausea, vomiting, dizziness, or shortness of breath
Reduced fetal movements or sudden swelling

Recommended Resources for Nursing Care of Preeclampsia

Reliable tools for nurses, students, and patient educators:

American College of Obstetricians and Gynecologists (ACOG): Evidence-based practice guidelines
Preeclampsia Foundation: Support materials and symptom checklists
National Institute for Health and Care Excellence (NICE): Clinical guidance for hypertensive disorders in pregnancy