C M PATEL COLLEGE OF NURSING

GANDHINAGAR

SUBJECT: OBSTETRICS AND GYNECOLOGY

NURSING
TOPIC: CASE STUDY ON ECLAMPSIA
BATCH: 2022-2023
YEAR: F.Y. MSc. NURSING

SUBMITTED TO: SUBMITTED BY:

Mrs Palak Patel Mrs Rashmi Goswami
Assistant Professor Roll No.
C.M.P.C.O.N C.M.P.C.O.N
Gandhinagar Gandhinagar

SUBMITTED ON:
 BIODATA OF THE CLIENT:

Name: Mrs Bhumikaben Vaghela

Age: 20 year
Sex: Female
Register No.: 000389
Ward: PNC-1
Bed No.: 09
Doctor’s unit: Dr Chirag
Admission date: 01/04/23
Education: 10th passed
Occupation: Housewife
Address: Bardoli
Nationality: Indian
Marital status: Married
LMP: 13/08/22
EDD: 20/05/23
Obstetric score: G2A1
Diagnostic: Eclampsia
Surgery: ----

 PAST HISTORY:
Medical and Surgical history:
She is having history of Hypertension since last 3 years.
No any surgical history in the past.
 Past obstetrical history:
Sr. Year Full Pre Abortion Type of Baby Remark
no term term delivery Sex Alive Still Weight
birth
1. 2021 - - Yes - - - - - -

 PRESENT OBSTETRICAL HISTORY:

First trimester Second trimester Third trimester

LMP: 13/08/2022 Quickening felt at 18 Patient had
Pregnancy diagnosed WOG. increased readings
by UPT. Continued Folic of BP since 30
Positive after 6 week acid. weeks.
of LMP Immunized with 2nd Tab. Labetalol 20mg
Started on Folic acid dose of Inj T.T. BD started.
supplementation. Now admitted with
Blood investigations the complains of
and scan done on headache
20/09/23 which h/o convulsion.
showed SLIUG. Treatment Inj.
No h/o fever, rashes, Labetalol 20mg and
excessive vomiting, Inj. MgSO4 4gm IV
bleeding etc. stat given.

 INTRANATAL PERIOD:
Duration of first stage: 8 hours
Duration of Second stage: 15 minutes
Duration of Third stage: 10 minutes
Total duration: 8 hours 25 minutes
 Episiotomy: ----
Characteristic of liquor: Clear
Type of Anaesthesia: Spinal anaesthesia
Amount of blood loss: approx. 500ml
Baby cry at birth: Yes

 CHIEF COMPLAINS:
Mrs Bhumikaben having
h/o headache and
h/o convulsion
 FAMILY HISTORY:

Sr. Name of Relationship Age Sex Education Occupation Health

no. the family with the Status
member patient
1. Mr Husband 25yr M 12th Farmer Healthy
Deepakbhai passed
2. Mrs Mother in 53yr F 8th passed Housewife Healthy
Savitaben law
3. Mr Father in law 56yr M 10th passed Farmer DM
Ganeshbhai

 SOCIOECONOMIC HISTORY:
Client lives in Joint family. She is a housewife & her husband
and father in law are an earning person in her family. Monthly
income are 30,000/-

 MENSTRUAL HISTORY:
Age of menarche: 12 year
Cycle: 30 days
Duration: 5 days
Regular/Irregular: Regular
 MARITAL STATUS:
Age of marriage: 18 year
Type of marriage: Non consanguineous
Duration of marriage: 2 years

 PRESENT PREGNANCY:
Date of admission: 01/04/2023
Height: 156 cm
Weight: 49 kg
Presentation: Cephalic
Position: LOA
Engaged/Not engaged/ Free: Not engaged
FHR: 148 beats/min

 HEAD TO TOE EXAMINATION:

 Head: Hairs were rough,
No skull injury and infection,
No any scar present
 Face: Face was looking anxious
 Eyes: Conjunctiva normal,
Eyelids are normal
Vision was normal
 Ear: No any discharge from the ear
Hearing acuity was normal
 Nose: No any nasal deviation
No any discharge from the nose
 Mouth: Lip was cracked
No gums bleeding
No any tooth decay
 Neck: Normal ROM
No Lymphadenopathy
No thyroid abnormality
  Chest:
Inspection – Breast were symmetrical
Breast enlargement seen
Primary and secondary areola was present
Montgomery tubercle was prominent
Nipple was erect
Colostrum was expressed
Palpation – No lump was found
 Abdomen:
Inspection – Striae Albicans was seen
Scar: caesarean scar present
Palpation – Fundal height: 20cm
Abdominal Girth: 85cm

 Back: No lordosis and no kyphosis

 Extremities: no signs of DVT
 Genital: Catherization is done

 VITAL SIGNS:
Parameters Patient value Normal range

Temperature 98 F 96.8-98.6 F

Pulse 72 beats/min 70-90 beats/min

Respiration 16 breaths/min 16-24 breaths/min

Blood pressure 170/120 mmHg 120/80 mmHg

 INVESTIGATIONS:
Sr. Name of Patient value Normal value
No. investigations

1. Blood count:
 RBC 3.13x10/cmm 4.2-5.4/cmm
 WBC 14100/cmm 4000-12500/cmm
 Platelet count 313000/cmm 150000-
450000/cmm

2. RBC indices:
 Haemoglobin 8.20g/dL 12-14g/dL
 Haematocrit 25.60% 37-47%
 MCV 81.80fl 80-99fl
 MCH 26.20pg 27-31pg
 MCHC 32g/dL 32-36g/dL

3. Serum Electrolytes:
 Serum Sodium 139mEq/L 120-160mEq/L
 Serum 4.73mEq/L 2.8-6.2mEq/L
Potassium

4. Blood group B positive

5. Blood sugar 110g/dL 70-160g/dL
6. HBsAg Negative
7. Abdominal USG Gravid uterus seen single live intrauterine
fetus with cephalic presentation.
Placenta located anteriorly
  TREATMENT:
Sr. Name of the Dose Route Frequency Action
No. drug

1. Inj Betnosol 20mg IM Stat NSAID

2. Inj MgSO4 4g IM Stat Vasodilator

3. Inj Pantop 40mg IV BD Proton pump

inhibitor

4. Inj Labetalol 20mg IV BD Beta blockers

5. Inj 2g IV BD Antibiotic
Cefosulbactum

6. Inj Gentamicin 240mg IV OD Antibiotic

7. Inj Emset 1A IV SOS Antiemetic

8. Inj Tramadol 1A IV SOS Opiate

analgesic

9. Tab Nifedipine 20mg Oral BD Calcium

channel
blocker
 DISEASE CONDITION:
ECLAMPSIA
 Introduction:
Hypertension is the most common medical problem
encountered during pregnancy.
Hypertensive disorder in pregnancy may cause maternal and
morbidity and leading cause of maternal mortality.
Hypertensive disorders are:
1. Pre Eclampsia
2. Eclampsia
3. Gestational hypertension
4. Chronic hypertension

 Definition:
Pre-Eclampsia when complicated with generalised tonic-
clonic convulsions and/or coma is called Eclampsia.
 Cause of convulsion:
- Anoxia
- Cerebral Edema
- Cerebral dysrhythmia
 Onset of fits:
Fits occur more commonly in third trimester
⁃ Antepartum (50%) fits occur before the onset of
labour
⁃ Intrapartum (30%) fits occur for the first time
during labour
⁃ Postpartum (20%) fits occur for the first time during
puerperium, usually within 48 hours of delivery
 Clinical features:
1. Premonitory stage:
⁃ The patient becomes unconscious.
⁃ There is twitching of the muscles of the face, tongue and
limbs.
⁃ Eyeballs rolled or turn towards one side and become
fixed.
⁃ This stage last for about 30 seconds.
2. Tonic stage:
⁃ The whole body goes into a tonic spasm.
⁃ The trunk opisthotonus, limbs are flexed and hands
clenched.
⁃ Respiration ceases and the tongue protrudes between the
teeth.
⁃ Cyanosis appears.
⁃ Eyeballs become fixed.
⁃ This stage last for about 30 seconds.
3. Clonic stage:
⁃ All the voluntary muscles undergo alternate contraction
and relaxation.
⁃ The twitching start in the face then involves one side of the
extremities and ultimately the whole body.
⁃ Biting of the tongue occurs.
 ⁃ Breathing is stertorous and blood stained frothy secretions
fill the mouth.
⁃ Cyanosis gradually disappears.
⁃ This stage last for 1-4 minutes.
4. Stage of coma:
⁃ Last for a brief period or in others deep coma persists till
another convulsion.
⁃ The patient appears to be in a confused state following the
fit and fails to remember the happenings.
⁃ The coma occurs without prior convulsion.
⁃ Fits are usually multiple, recurring at varying intervals.
⁃ When it occurs continuously it is called status eclampticus.
 Other symptoms may be:
⁃ Asymptomatic
⁃ Headache
⁃ Visual disturbance
⁃ Epigastric pain
⁃ Edema
⁃ High BP
⁃ Fluid retention
⁃ Brisk reflex
⁃ Fundal level less than approximate date
 Management:
o Prediction and prevention:
- In majority of cases, Eclampsia is preceded by severe
pre-eclampsia. Thus the prevention of eclampsia rests
on early detection and effective institutional treatment
with judicious termination of pregnancy during pre-
eclampsia. However, eclampsia can occur bypassing
the pre-eclamptic state and as such, it is not always a
 preventable condition. Eclampsia may present in
atypical ways, hence it is at times difficult to predict.
- Use of antihypertensive drugs, prophylactic
anticonvulsant therapy and timely delivery are
important steps. Close monitoring during labour and
24 hours' postpartum, are also important in prevention
of eclampsia. Magpie trial (2002) showed prophylactic
use of magnesium sulphate lowers the risk of
eclampsia. Unfortunately 30-85 per cent of cases of
eclampsia remained unpreventable.
o First aid treatment outside the hospital:
- The patient, either at home or in the peripheral health
centres should be shifted urgently to the tertiary
referral care hospitals. Transport of an eclamptic
patient to a tertiary care centre is important. Such a
patient needs neonatal and obstetric intensive care
management.
- Important steps in transport are:
 All mater records and a detailed summary should
be sent with the patient.
 BP should be stabilised and convulsions should
be arrested.
 Magnesium sulphate (4 gm IV loading dose with
10 gm IM) is given.
 Labetale 20 mg IV is given to control
hypertension.
 Diuretic is given if there is pulmonary oedema.
  Diazepam used should be given 5 mg slowly over
one minute period to avoid apnoea or cardiac
arrest.
 One medical personnel or a trained midwife
should accompany the patient in the ambulance
equipped to prevent injury, recurrent fits and to
clear air passage.
o General management (medical and nursing)
 Supportive care:
1. To prevent serious maternal injury from fall,
2. Prevent aspiration
3. To maintain airway
4. To ensure oxygenation
- Patient is kept in a railed cot and a tongue blade is
inserted between the teeth. She is kept in the lateral
decubitus position to avoid aspiration.
- Vomitus and oral secretions are removed by frequent
suctioning, oxygenation is maintained through a face
mask (8-10 L/min) to prevent respiratory acidosis.
Oxygenation monitored using a transcutaneous pulse
oximeter.
- Arterial blood gas analysis is needed when O2 ,
saturation falls below 92 %.
- Sodium bicarbonate is given when the pH is below
7.10.
- The patient should have a doctor or at least a trained
midwife for constant supervision.
  Detailed history is to be taken from the relatives,
relevant to the diagnosis of eclampsia, duration of
pregnancy, number of fits and nature of medication
administered outside.
 Examination
- Once the patient is stabilised a thorough but quick
general, abdominal and vaginal examination are made
- A self retaining catheter is introduced and the urine is
tested for protein.
- The continuous drainage facilitates measurement of
the urinary output and periodic urine analysis,
 Monitoring:
- Half hourly pulse, respiration rates and blood pressure
are recorded.
- Hourly urinary output is to be noted, If undelivered the
uterus should be palpated at regular intervals to detect
the progress of the labor and the fetal heart rate is to be
monitored.
- Immediately after a convulsion, fetal bradycardia is
common.
 Fluid balance:
- Crystalloid solution (Ringer's solution) is started as a
first choice. Total fluids should not exceed the
previous 24 hours urinary output plus 1000 ml
(insensible loss through lungs and skin).
- Normally it should not exceed 2 litres in 24 hours.
- Infusion of balanced salt solution should be at the rate
of 1 ml/kg per hour. In pre-eclampsia-eclampsia
 although there is hypervolemia, the tissues are over
loaded.
- An excess of dextrose or crystalline solutions should
not be used as it will aggravate the tissue overload
leading to pulmonary oedema and adult respiratory
distress syndrome.
- Colloids (albumin or haemaccel) remain in the
vascular tree and they withdraw fluids from the
interstitial space.
- Unless used carefully, they can lead to circulatory
overload.
- CVP monitoring is needed for a patient with severe
hypertension and reduced urine output.
- In pre-eclampsia, eclampsia, both the PCWP and CVP
appear to be in the low to normal range.
- Invasive haemodynamic monitoring is rarely
indicated.
 Antibiotic
- To prevent infection, Ceftriaxone 1 gm IV twice
daily is given.
o Specific management: Anticonvulsant and sedative
regime: The aim is to control the fits and to prevent its
recurrence.
⁃ Magnesium sulphate is the drug of choice. It acts
as a membrane stabilizer and neuroprotector. It
reduced motor endplate sensitivity to acetylcholine
Magnesium blocks neuronal calcium influx also. It
induces cerebral vasodilatation, dilates uterine
 arteries, increases production of endothelial
prostacyclin and inhibits platelet activation.

Regimen for MgSO4 for the management of eclampsia

Regimen Loading dose Maintenance
dose
Intramuscular 4gm IV over 3-5min. 5gm IM 4 hourly
(Pritchard ) followed by 10 gm deep IM in alternate
(5gm in each buttock) buttock
Intravenous 4-6gm IV over 15-20 min. 1-2gm/hr IV
(Zuspan or Sibai) infusion

Other regimens are: (1) Lytic cocktail (Menon 1961) using

chlorpromazine, promethazine and Pethidine. (2) Diazepam
(Lean) and (3) Phenytoin
⁃ Benefits of Magnesium sulphate:
i. It controls fits effectively without any depression effect
to the mother or the infant.
ii. Reduced risk of recurrent convulsions.
iii. Significantly reduced maternal death rate (3%) and
iv. Reduced perinatal mortality rate.
Antihypertensive and diuretics
 Inspite of anticonvulsant and sedative regime, if the
blood pressure remains more than 160/110 mm Hg,
antihypertensive drugs should be administered.
 Drugs commonly used are parenteral, Hydralazine,
Labetalol, Calcium channel blockers or
Nitroglycerine
  Presence of pulmonary oedema requires diuretics.
In such cases, the potent one (frusemide) should be
administered in doses of 20-40 mg intravenously
and to be repeated at intervals.
Management during fit:
a) In the premonitory stage, a mouth gag is placed in
between the teeth to prevent tongue bite and should be
removed after the clonic phase is over.
b) The air passage is to be cleared off the mucus with a
mucus sucker. The patient's head is to be turned to one
side and the pillow is taken off. Raising the footend of
the bed facilitates postural drainage of the upper
respiratory tract.
c) Oxygen is given until cyanosis disappears.
Status eclampticus:
a) Thiopentone sodium 0.5 gm dissolved in 20 ml of 5%
dextrose is given intravenously very slowly.
b) The procedure should be supervised by an expert
anaesthetist. If the procedure fails, use of complete
anaesthesia, muscle relaxant and assisted ventilation can
be employed.
c) In unresponsive cases, caesarean section in ideal
surroundings may be a life saving attempt
Treatment of complications:
Prophylactic use of antibiotics markedly reduces the
complications like pulmonary and puerperal infection.
Pulmonary oedema:
a) Frusemide 40 mg IV followed by 20 g of Mannitol IV
reduces pulmonary oedema and also prevents adult
respiratory distress syndrome.
b) Pulse oximeter is very useful to monitor such a patient.
c) Aspiration of the mucus from the tracheobronchial tree
by a suction apparatus is done.
Heart failure:
Oxygen inhalation, parenteral Lasix and digitalis are
used.
Anuria:
Dopamine infusion (1 µg/kg) is given with oliguria when
CVP is >8 mm Hg. It is often surprising that urine output
returns to normal following delivery.
Hyperpyrexia:
It is difficult to bring down the temperature as it is central in
origin. However, cold sponging and antipyretics may be tried.
Psychosis:
Chlorpromazine or Eskazine (trifluoperazine) is quite
effective.
Intensive care monitoring:
a) Patient with multiple medical problems needs to be
admitted in an intensive care unit where she is looked
 after by a team consisting of an obstetrician, a physician
and an expert anaesthetist.
b) Cardiac, renal or pulmonary complications are managed
effectively.
c) Use of blood gas analyser (to detect hypoxia and
acidosis), pulse oximeter and central venous pressure
monitor should be done depending on individual case.
d) A deeply unconscious patient with raised intracranial
pressure needs steroid and or diuretic therapy CT scan or
MRI may be needed for the diagnosis
SCHEME OF OBSTETRIC MANAGEMENT OF ECLAMPSIA

ECLAMPSIA

Anticonvulsant, Antihypertensive, Diuretic

Not in labor In labor

Fits controlled Fits not controlled

ARM C.S.
Baby
Forceps, ventouse to
cut short 2nd stage

Term Preterm Dead

Steroid Induction of labor (PGE2 gel)

Delivery
Delivery
Delivery
Induction (PGE2 gel, ARM, Oxytocin)
 Fits not controlled

(6-8 hours)

Delivery

To assess the induction score

Favourable Unfavourable

Induction C.S.
 ARM
 Oxytocin
 NURSING PROCESS:

List of nursing Diagnosis

1. Decreased cardiac output related to decreased venous

return as evidenced by change in blood pressure.

2. Ineffective uteroplacental tissue perfusion related to

vasoconstriction as evidenced by premature delivery.

3. Excess fluid volume related to increase fluid intake as

evidenced by edema

4. Activity intolerance related to hypertension as evidenced

by slight headache.

5. Deficient knowledge related to unfamiliarity with

information resources as evidenced by inaccurate follow
up of instructions.

6. Ineffective breastfeeding related to infant prematurity as

evidenced by failure to latch.

7. Risk for infection related to caesarean section.

Assessment Diagnosis Expected Intervention Rationale Evaluation
outcome
Subjective Decreased The client - Assess blood - Blood pressure may The client BP
data: cardiac output will maintain pressure and be elevated because is 156/90
Client says related to normal blood pulse every of increase in mmHg.
that “I am not decreased pressure. one hour. systemic vascular
feeling well”. venous return - Monitor and resistance.
as evidenced measure the - The kidneys respond
by change in clients urine to reduced cardiac
blood pressure. output. output by retaining
- Provide water and sodium.
frequent rest - Improves venous
periods with return, cardiac output
bed rest. and renal placental
- Instruct the perfusion.
Objective client to - Decreases venous
data: elevate legs stasis and may also
There is when sitting reduce the incidence
increase in the or lying of thrombus and
blood pressure down. embolus formation.
which is - Administer - Promotes relaxation
170/95mmHg antihypertens of cardiovascular
ive smooth muscles.
medications.
Assessment Diagnosis Expected Intervention Rationale Evaluation
outcome
Subjective Excess fluid The client is - Assess the - A rise in BP may Edema is
data: volume related adheres to clients vital happen in response to reduced
Client says to increase therapeutic signs and catecholamines,
that “there is fluid intake as regimen and closely vasopressin, and
swelling on evidenced by participates in monitoring prostaglandins.
my legs”. edema monitoring. BP and pulse - Urine output is a
rate. sensitive indicator of
- Monitor circulatory blood
intake and volume.
output. Note - Insufficient protein
urine color. increases the risk of
- Encourage edema formation.
the client to - This attitude will
increase helps to decrease
Objective protein edema on legs.
data: intake.
Ankle edema - Encourage
was present the client to
elevate legs
while lying
down.
Assessment Diagnosis Expected Intervention Rationale Evaluation
outcome
Subjective Deficient The client - Assess the - Establishes a The client is
data: knowledge verbalizes client’s database and able to
Client says related to understanding knowledge of provides information. follow
that” please unfamiliarity of the disease the disease - Helps ensure that the instructions
provide me with process and process. client seeks timely and has got
with the information appropriate - Provide treatment and may little
necessary resources as treatment information prevent knowledge
information” evidenced by plan. about complications. about her
inaccurate signs/sympto Instruct the client to condition.
follow up of ms indicating report headache.
instructions. worsening of - When the client
the condition. understands the
Objective - Inform the consequences of
data: client about inadequate
Inaccurate her health intervention and is
follow up of status and motivated to achieve
instruction. result of tests. health.
- Reinforce the - Lack of engagement
importance of in the treatment plan
adhering to will result for failure
treatment of therapy.
regimens.
Assessment Diagnosis Expected Intervention Rationale Evaluation
outcome
Subjective Ineffective Mother will - Assess - This will helps to Mother uses
data: breastfeeding implement mother’s understand the new
Client says related to infant two knowledge. cultural conflicts and technique for
that” my child prematurity as techniques to - Teach about myths or breastfeeding
is not taking evidenced by improve the latching misunderstandings
breastmilk”. failure to latch. breastfeeding. technique. - Promotes a better
- Encourage experience for
skin to skin breastfeeding.
contact of - Skin to skin holding
baby and the promotes
mother breastfeeding
Objective - Assist in initiation.
data: proper - Proper positioning
There is breastfeeding can promote
improper positioning. effective
latching. - Encourage breastfeeding and
the mother reduce discomfort.
for kangaroo
mother care.
 HEALTH EDUCATION:

Gave health education regarding:

 Postnatal care
 Maintaining personal hygiene
 Postnatal exercise
 Regular check-up and follow up
 Family planning methods
 Breastfeeding
1. Postnatal advise :-
- Advise her to provide breastfeeding to her child day and
night.
- Advise her for regular check-up and follow up
- Advise her to timely immunize her child.
- Advised her to take 8 hours rest in night and 2 hours in
afternoon.
2. Maintaining personal hygiene:-
- Advise for daily bath, mouth care, hair care and breast care.
- Advise her to clean her breast and nipple before each feed.
 - To wash her hand before and after breastfeeding.
- Advise her to clean perineal area with plain water after
each urination and defecation.
3. Regular check-up and follow up: -
- Postpartum care is very important as it can prevent many
life threatening health complications.
- Advised her to take all medicine regularly and come for
routine check-up according doctor’s order.
4. Postnatal Exercise and its benefits:-
- Explained and taught about kegel exercise and, pelvic floor
exercise, abdominal breathing and walking.
- Postnatal exercise helps to restore muscle strength and firm
up body.
- Raises energy level and improves sense of wellbeing.
- Promotes weight loss.
5. Use of Family planning methods and its benefits:-
- Advised her to use of various family planning methods.
- Enables to regain her health after delivery.
- Gives enough time and opportunity to love and provide
attention to her child.
- Provide spacing between two childrens.
6. Breastfeeding and its importance:-
- Advise her to breastfeed her child daily.
- It can help protect the child against short and long term
illness and disease.
- Provide nutrition to your child.
- Provide protection from disease as it contains antibodies.
- Helps to gain weight of your child.
- Demonstrate her about different kinds of positions.
 PROGRESS NOTES:
Day:-1
My client Bhumikaben was admitted in civil hospital Gandhinagar
with complains of abdominal pain, and history of convulsion.
Treatment received at the time of admission was Inj Lobet 10mg IV
stat, Inj MgSO4 4mg IV stat and sample is taken for routine blood
examination.
She was taken for emergency LSCS
During time of admission her vital sign was:
Vital signs Patient value Normal value
Temperature 98 F 98.6 F
Pulse 76bpm 70-90bpm
Respiration 18bpm 18-24bpm
Blood pressure 170/100mmHg 120/80mmHg

Day 2:
Bhumikaben was feeling much better on the second day. Her health
status was much better.
Advise to breastfeed her child.
Advise for KMC
Advise for newborn care
Vital signs were recorded
Vital signs Patient value Normal value
Temperature 98 F 98.6 F
Pulse 78bpm 70-90bpm
Respiration 16bpm 18-24bpm
Blood pressure 155/100mmHg 120/80mmHg
Same medicine was continued on the second day.
Day 3:
On 3rd day, her health improved much better.
She was fully co-operative in all the procedures.
Advise her for ambulation.
Assist her with different positions of breastfeeding.
The same medications were continued on the third day.
Following vital sign recorded on 3rd day.
Vital signs Patient value Normal value
Temperature 98 F 98.6 F
Pulse 80bpm 70-90bpm
Respiration 22bpm 18-24bpm
Blood pressure 150/90mmHg 120/80mmHg

Day 4:
On the fourth day, she was feeling much better.
Her appetite was gradually improved.
Advised to eat good nutritious food.
She was assisted in meeting the hygienic needs.
She was able to get out of bed without any support.
Vital signs were checked and recorded.
Vital signs Patient value Normal value
Temperature 98 F 98.6 F
Pulse 78bpm 70-90bpm
Respiration 20bpm 18-24bpm
Blood pressure 145/85mmHg 120/80mmHg
Same medications were continued.
Appetite was much better. General condition was also improved.
Health education was given on Postnatal care, Family planning,
Personal hygiene, Newborn care, Postnatal exercise.
 SUMMARY
 My Patient came with complain of abdominal pain and
convulsion.
 Patient is 2nd gravid women.
 On admission she is having abdominal pain and came with the
history of convulsion so she is taken for emergency caesarean
section.
 She delivered a male child with birth weight of 2500gm
 After providing 5 days care with health education to her she is
maintaining stable vital parameters, so doctors gave discharge to
my client.
 CONCLUSION:
During my clinical posting in civil hospital in antenatal ward, I got
chance to provide care to, Mrs Bhumikaben with diagnosis of
Eclampsia by this study I learn in detail about Eclampsia definition,
causes and its management. I thank my client for her cooperation and
my clinical coordinator for her valuable guidance.
 BIBLIOGRAPHY

1. Basvanthappa B.T : “TEXT BOOK OF MIDWIFERY AND

REPRODUCTIVE HEALTH NURSING”; 1st edition 2006,
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2004; New central book agency publication, Calcutta. Page
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3. Jacob Anamma : “A COMPREHENSIVE TEXT BOOK OF
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4. Kumari Neelam; (2010); 1st edition; “MIDWIFERY AND
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6. Rao Kamini “TEXT BOOK OF MIDWIFERY AND
OBSTETRICS FOR NURSES”; First edition, 2011, Elsevier
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 REFERENCES
 https://nurseslabs.com/preeclampsia-gestional-
hypertensive-disorders-nursing-care-plans/6/
 https://www.nursetogether.com/preeclampsia-
nursing-diagnosis-care-plan/
 https://www.slideshare.net/abdullahkhamis777/pre
e-eclampsia
 https://www.nursetogether.com/postpartum-
nursing-diagnosis-care-plan/
 https://www.nursetogether.com/breastfeeding-
nursing-diagnosis-care-plan/
 https://www.slideshare.net/AbhilashaVerma1/ecla
mpsia-ppt