Gestational Hypertension, Pre-Eclampsia, and Eclampsia (10 Questions)

1. Mme St-Jean, a 34-year-old G1P0 at 36 weeks gestation, is admitted to the antenatal unit for monitoring of mild Preeclampsia. Her baseline blood pressure was 142/92 mmHg. The physician's orders include: "BP q4h, daily weights, dipstick urine q shift." At 08:00, Mme St-Jean calls the nurse and states, "I have a terrible pain right here," pointing to her upper right abdomen (epigastric/RUQ area). She also complains of seeing "floating spots" in her vision. Her BP is now 164/112 mmHg.

Question:
What is the clinical significance of the pain Mme St-Jean is describing? *
2. Mme Gauthier, 33 weeks gestation, is receiving an IV infusion of Magnesium Sulfate 2g/hr for seizure prophylaxis due to severe Preeclampsia. You enter the room to perform your hourly assessment. You find Mme Gauthier drowsy and slurring her speech slightly. Her assessment data is: BP 148/96 mmHg, Pulse 88 bpm, Respiratory Rate 10 breaths/min, deep tendon reflexes (DTRs) are absent (0), and urine output was 20 mL in the last hour.

Question:
What is the nurse’s priority immediate intervention? *
3. Following the assessment in the previous scenario (Mme Gauthier), the physician arrives and confirms Magnesium toxicity. The patient’s respiratory rate has dropped to 8 breaths/min. The physician orders the immediate administration of the antidote.

Question:
Which medication must the nurse have readily available at the bedside for this emergency? *
4. Mme Beaulieu, 30 weeks gestation, presents to triage complaining of "flu-like symptoms," general malaise, and nausea for 2 days. Her BP is 150/96 mmHg. The physician orders a "Preeclampsia Workup."

The lab results return:
*Hemoglobin: 110 g/L
*Platelets: 85,000 /µL (Low)
*AST (Liver Enzyme): 120 U/L (Elevated)
*LDH: Elevated

Question:
Based on these lab values, what diagnosis should the nurse anticipate? *
5. Mme Cloutier, admitted with severe Preeclampsia, suddenly begins to have a tonic-clonic seizure while you are speaking with her. She becomes rigid and her jaw clenches.

Question:
What is the priority safety intervention during the active seizure phase? *
6. Mme Dumont, 38 weeks gestation, has a BP of 170/110 mmHg. The physician orders: "Labetalol 20 mg IV push over 2 minutes." Before administering the medication, you assess the patient.

Question:
Which assessment finding would require the nurse to hold the medication and notify the physician? *
7. You are performing a CNS assessment on Mme Ferland, who has Preeclampsia. To assess for clonus, you support her leg and briskly dorsiflex her foot (push it towards her head) and then hold the stretch. You feel the foot tap against your hand three times.

Question:
How should the nurse document and interpret this finding? *
8. Mme Lapointe delivered a healthy baby boy 3 days ago. She had mild Gestational Hypertension during labor but required no medication. She is being discharged today. Her BP is 130/84 mmHg.

Question:
What crucial instruction must be included in her discharge teaching regarding her hypertensive status? *
9. Mme Morissette is admitted with Severe Preeclampsia. She is on bedrest, and her reflexes are +4. The plan of care includes "Seizure Precautions."

Question:
Which environmental modification is most appropriate to include in her care plan? *
10. Mme Touchette, 34 weeks gestation with Severe Preeclampsia, is receiving IV Magnesium Sulfate and IV Lactated Ringer's. During your assessment, she complains of "shortness of breath" and a "tight chest." Her O2 saturation is 91% on room air. Upon auscultation, you hear crackles in the lung bases.

Question:
What is the likely cause of these symptoms, and what is the nursing action? *