Nursing Interventions of Eclampsia Patient

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 the late second trimester or the third trimester. It is the 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 patients to prevent further convulsion and safely delivered the baby.

Nursing Intervention for Eclampsia Patient:

Some key nursing interventions of eclampsia patient have pointed out the below:

1. Open intravenous line in both hands and start fluid as order.
2. Indwelling foley’s catheter to monitor urine output and most of the magnesium excrete by urine.
3. Keep the patient NPO to prevent aspiration.
4. Keep the patient’s lateral position to avoid aspiration of vomits and secretions.
5. Give the suction of oral secretion and vomiting gently.
6. Insert a padded tongue blade or airway tube to avoid tongue bite and open the airway properly.
7. Avoid inducing gag reflex of eclampsia patient.
8. Ensure oxygenation 8-10 L/min through a face mask to avoid hypoxia and metabolic acidosis.
9. Analyze Arterial Blood Gas (ABG) if oxygen saturation showing abnormal (less than 92%).
10. Keep bedside rails up to prevent fall of eclampsia patients.
11. Use of physical restraints as needed.
12. Check vital signs every 15 minutes during the critical time (First 1-4hours).
13. Start in. Magnesium Sulfate loading dose of 6gms over 15-20minutes as order.
14. Carefully administer maintenance dose of 2gm per hour as a continuous intravenous solution as ordered.
15. If repeatedly convulsion occurs, give in. Sodium Amobarbital 250mg intravenous over 3-5minutes as the doctor ordered.
16. Do not administer inj. Diazepam to stop the convulsion.
17. I use injection diazepam then ensure intravenous and keep the ready skilled person who can intubate the patient immediately.
18. If the respiratory arrest occurs ensure ventilation immediately.
19. Carefully monitor magnesium toxicity like flushing, a feeling of warmth, nausea, vomiting, double vision, and slurred speech.
20. Try to keep systolic blood pressure between 140mmHg to 160mmHg and diastolic blood pressure 90mmHg to 110mmHg as order.
21. Give in. Hydralazine 5 to 10mg bolus or in. Labetalol 20 to 40mg every 15 minutes as order.
22. Give oral Nifediphine 10 to 20mg every 30 minutes as order if the patient is conscious.
23. Check fetal heart rate during and immediately following a convulsion.
24. If Bradycardia persists beyond 10 to 15 minutes despite all efforts, check the eclampsia patient of abruption placenta.
25. Prepare the patient for delivery that is indicated for the patient as the doctor ordered.
26. After delivery carefully monitor the vital sign of the patient and evaluate the risk of further convulsion.
27. Strictly monitor intake output and urine color.
28. If Oliguria present, inform the doctor and increase fluid intake and reduce the dose of magnesium sulfate.
29. Ensure Magnesium Sulfate at least 24hours after delivery or for at least 24 hours after the last convulsion.
30. After delivery, promote adequate rest for eclampsia patients by ensuring a quiet environment.

Maria Mona

Maria Khatun Mona is a Founder and Editor of Nursing Exercise Blog. She is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at “maria.mona023@gmail.com”