Key Concepts
Overview
Clinical significance: Preeclampsia affects 5–8% of pregnancies and is a leading cause of maternal and perinatal morbidity and mortality globally. The RN must recognize the condition, assess severity, administer and monitor magnesium sulfate (MgSO₄), and prepare for eclamptic seizures. These are high-stakes, high-frequency NCLEX-RN topics. Diagnostic criteria (ACOG): - BP ≥140/90 mmHg on two occasions ≥4 hours apart (or ≥160/110 on one occasion) - Plus at least ONE of: - Proteinuria: ≥300 mg protein in 24h urine OR protein:creatinine ratio ≥0.3 OR dipstick ≥2+ (when quantitative testing unavailable) - Thrombocytopenia (platelets <100,000) - Renal insufficiency (creatinine >1.1 mg/dL or doubling of creatinine) - Liver transaminase elevation (>2× normal) - Pulmonary edema - Severe headache unresponsive to medication OR visual disturbances Key distinction: Preeclampsia can occur WITHOUT proteinuria if other severe features are present (revised ACOG 2013 criteria). Eclampsia: New-onset grand mal seizure in a patient with preeclampsia. Medical emergency. On the exam, writers often pair stable-sounding options with unstable data—notice the mismatch before you commit. If the stem names a license or role, reread that line; scope errors are classic...