Preeclamptic Penny — Preeclampsia & Magnesium Sulfate
BP ≥ 140/90 after 20 weeks + proteinuria — headache means danger
Penny's headache started this morning and nothing touched it. Her rings will not come off, she sees spots when she stands, and her blood pressure reads 168/108.
Penny is 34 weeks pregnant with a blood pressure of 168/108, protein in her urine, a headache that will not lift and swollen hands. Magnesium sulfate prevents seizures; calcium gluconate reverses it. Losing deep tendon reflexes is the first warning that magnesium is too high.
Read Preeclamptic Penny's full story →The story arc
The setup
First pregnancy, 34 weeks, blood pressure creeping up over three prenatal visits with 2+ protein on dipstick.
The turn
A headache no medication relieves, visual spots, and pain under her right ribs.
The crisis
BP 168/108, platelets 92,000, AST elevated — HELLP is developing and delivery is the only cure.
The save
Magnesium sulfate loading dose then infusion, a quiet dim room, seizure precautions, hourly reflexes, urine output and respiratory rate, calcium gluconate at the bedside.
NCLEX study section — Preeclampsia & Magnesium Sulfate
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Maternal & Newborn
Take this chapter into practice questions on the same topic.