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.
Comparison
Progression4 stages
Progression — 4 stages
Without Severe Features
What's happening- New HTN + proteinuria after 20 weeks
Key findings- BP 140–159 / 90–109
- Proteinuria ≥ 300 mg/24 hr
Nursing focus- Monitor BP + weekly labs
- Teach warning signs to report
With Severe Features
What's happening- End-organ involvement begins
Key findings- ★BP ≥ 160/110
- Severe headache, visual changes
- Epigastric / RUQ pain
Nursing focus- Mag sulfate seizure prophylaxis
- Quiet room; seizure precautions
Eclampsia
What's happening- ★Generalized tonic-clonic seizure
Key findings- Seizure defines it — any BP level
Nursing focus- Protect airway; mag sulfate; deliver
HELLP Syndrome
What's happening- Hemolysis + liver injury + low platelets
Key findings- ★↑ LDH, ↑ AST/ALT, plt < 100k
- Hemolysis on blood smear
Nursing focus- Monitor bleeding; plan delivery
★ marks the fact that sets a column apart.
Clinical Pearl
Headache + vision changes + epigastric pain = severe features → start mag; seizure = eclampsia → deliver.
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