# A client with severe preeclampsia begins having a generalized seizure. Place the nurse's actions in priority order.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=395537&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A client with severe preeclampsia begins having a generalized seizure. Place the nurse's actions in priority order.

Turn the client to a side-lying position, protect the head, and remove nearby hazards without restraining movement.

Administer the prescribed magnesium-sulfate loading dose and monitor respirations, reflexes, and urine output.

Stay with the client, call for immediate assistance, and note the seizure start time.

Maintain a patent airway, provide oxygen as indicated, and keep suction available without forcing an object into the mouth.

After stabilization, reassess maternal blood pressure and neurologic status, evaluate fetal status, and document the event and response.

## Explanation

Stay and summon help, position side-lying and prevent injury, then support airway and oxygenation. Give prescribed magnesium sulfate to control and prevent recurrent eclamptic seizures. Maternal reassessment precedes interpretation of fetal status and documentation after stabilization.

## In-depth explanation

Correct sequence
Stay and call → side-lying protection → airway and oxygen → magnesium sulfate → maternal and fetal reassessment.

Why this is correct
During the seizure, the nurse prevents falls and aspiration without restraining the client or placing anything in the mouth. Airway and oxygenation are supported as the seizure ends. Magnesium sulfate is the recommended anticonvulsant for eclampsia and requires monitoring for respiratory depression, reduced reflexes, and impaired renal clearance.

NCLEX decision rule
Stabilize the pregnant client first. Fetal oxygenation depends on maternal airway, ventilation, and circulation.Reference
1WHO recommendations for pre-eclampsia and eclampsia

## Clinical scenario

Eclampsia emergency
The client is in a labor room with padded side rails. Magnesium sulfate is prescribed by protocol but has not yet been started. The fetal monitor remains attached.

## Key concepts

- **Eclampsia** — New-onset seizure associated with a hypertensive disorder of pregnancy when another cause is not more likely.
- **Magnesium Sulfate** — The recommended anticonvulsant for treatment and prevention of recurrent eclamptic seizures.
- **Side-Lying Position** — A position that can help airway drainage and reduce aspiration risk.

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