Key Concepts
Introduction and Epidemiology
Hypertensive disorders complicate 5โ10% of all pregnancies and are among the leading causes of maternal and perinatal morbidity and mortality worldwide. In 2024โ2026, hypertensive disorders collectively account for approximately 14% of maternal deaths in developed countries. Why this matters for NCLEX/REx-PN: Hypertensive disorders in pregnancy appear on EVERY maternal-newborn examination. Mastery of the classification system, diagnostic criteria, assessment findings, and nursing priorities is essential for exam success. The four categories of hypertensive disorders in pregnancy (ACOG classification): 1. Chronic hypertension โ predating pregnancy or diagnosed <20 weeks 2. Gestational hypertension โ new-onset โฅ20 weeks WITHOUT proteinuria or end-organ damage 3. Preeclampsia โ new-onset hypertension โฅ20 weeks PLUS proteinuria OR end-organ damage 4. Chronic hypertension with superimposed preeclampsia โ worsening hypertension + new proteinuria or end-organ dysfunction in a patient with prior chronic HTN Additional related conditions: 5. Eclampsia โ preeclampsia + new-onset seizure not attributable to another cause 6. HELLP syndrome โ Hemolysis + Elevated Liver enzymes + Low Platelets (a severe variant of preeclampsia) On the exam, writers often pair stable-sounding options with unstable dataโnotice the mismatch before you...