What is Eclampsia?
Eclampsia is a life threatening complication of pregnancy followed by previously diagnosed with pre-eclampsia that experienced seizures or coma. It usually develops in late second trimester or in the third trimester. It is most fatal experience for pregnant women during pregnancy. In this critical situation, nurses play a vital role to avoid maternal and fetal injury. Careful nursing intervention helps eclampsia patient to prevent further convulsion and safely delivered the baby.
Nursing Intervention for Eclampsia Patient:
Some key nursing interventions of eclampsia patient have pointed out in the below:
- Open intravenous line in both hand and start a fluid as order.
- Indwelling foley’s catheter to monitor urine output and most of the magnesium excrete by urine.
- Keep the patient NPO to prevent aspiration.
- Keep the patient lateral position to avoid aspiration of vomits and secretions.
- Give suction of oral secretion and vomiting gently.
- Insert padded tongue blade or airway tube to avoid tongue bite and open the airway properly.
- Avoid inducing gag reflex of eclampsia patient.
- Ensure oxygenation 8-10 L/min through face mask to avoid hypoxia and metabolic acidosis.
- Analyze Arterial Blood Gas (ABG) if oxygen saturation showing abnormal (less than 92%).
- Keep bed side rails up to prevent fall of eclampsia patient.
- Use of physical restraints as needed.
- Check vital sign every 15 minutes during critical time (First 1-4hours).
- Start inj. Magnesium Sulfate loading dose of 6gms over 15-20minutes as order.
- Carefully administer maintenance dose of 2gm per hour as a continuous intravenous solution as order.
- If repeatedly convulsion occurs, give inj. Sodium Amobarbital 250mg intravenous over 3-5minutes as doctor order.
- Do not administer inj. Diazepam to stop the convulsion.
- If use injection diazepam then ensure intravenous and keep ready skilled person who can intubate the patient immediately.
- If respiratory arrest occurs ensure ventilation immediately.
- Carefully monitor magnesium toxicity like flushing, a feeling of warmth, nausea, vomiting, double vision and slurred speech.
- Try to keep systolic blood pressure between 140mmHg to 160mmHg and diastolic blood pressure 90mmHg to 110mmHg as order.
- Give inj. Hydralazine 5 to 10mg bolus or inj. Labetalol 20 to 40mg every 15 minutes as order.
- Give oral Nifediphine 10 to 20mg every 30 minutes as order if patient conscious.
- Check fetal heart rate during and immediately following a convulsion.
- If Bradycardia persists beyond 10 to 15 minutes despite all efforts, check the eclampsia patient of abruption placenta.
- Prepare the patient for delivery that is indicated for patient as doctor order.
- After delivery carefully monitor vital sign of patient and evaluate risk of further convulsion.
- Strictly monitor intake output and urine color.
- If Oliguria present, inform doctor and increase fluid intake and reduce the dose of magnesium sulfate.
- Ensure Magnesium Sulfate at least 24hours after delivery or for at least 24 hours after last convulsion.
- After delivery, promote adequate rest for eclampsia patient by ensuring quite environment.