spectrum comparison
Preeclampsia Spectrum: Without Severe Features → With Severe Features → Eclampsia → HELLP
Preeclampsia isn't one disease — it's a progressive spectrum where each stage demands a different intervention and delivery timeline. Picking the wrong stage on the NCLEX means choosing expectant management when the patient needs emergent delivery, or missing the mag sulfate threshold entirely.
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Progression4 stages
Progression — 4 stages
No Severe Features
What's happening- Mild HTN + proteinuria after 20 weeks
Key findings- BP 140–159 / 90–109
- No severe symptoms or lab changes
Nursing focus- Monitor BP + weekly labs
- Teach warning signs to report
- Deliver at 37 weeks
With Severe Features
What's happening- End-organ involvement begins
Key findings- ★BP ≥ 160/110
- Severe headache, visual changes
- Epigastric / RUQ pain
Nursing focus- Magnesium sulfate
- Seizure precautions
- Deliver at ≥ 34 weeks
Eclampsia
What's happening- ★Generalized tonic-clonic seizure
Key findings- Seizure defines it — any BP level
Nursing focus- Protect airway, turn to side
- Magnesium sulfate
- Seizure precautions
- Deliver once stable, any gestation
HELLP Syndrome
What's happening- Hemolysis + liver injury + low platelets
Key findings- ★↑ LDH, ↑ AST/ALT, plt < 100k
- Hemolysis on blood smear
- Epigastric / RUQ pain
Nursing focus- Magnesium sulfate
- Seizure precautions
- Monitor for bleeding/DIC
- Deliver once stable, any gestation
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Clinical Pearl
Headache + vision changes + epigastric pain = severe features → start mag; seizure = eclampsia → deliver.
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