• Assist with Maternal Resuscitation, Stabilize for Prompt Delivery, and Educate
• Assess patient status and maintain airway/oxygenation during seizure if possible, or assist with/establish respiratory support immediately after seizure with supplemental oxygen. Closely monitor pulse oximetry and ABG values, and administer sodium bicarbonate if ordered when pH is < 7.10
• Administer prescribed magnesium sulfate (2–4 g I.V. every 15 minutes [maximum 6 g] until seizures stop, then continuous infusion of 1–3 g/hour)
• Monitor treatment efficacy and for magnesium toxicity. (For details, see Red Flags, below)
• Administer diazepam, LORazepam, phenytoin, or PHENobarbital as ordered for seizure control if magnesium sulfate is ineffective
• Frequently assess BP; administer prescribed antihypertensive medication (e.g., hydrALAZINE, labetalol) to prevent cerebrovascular injury
• Closely monitor for recurring seizures; follow facility protocols to prevent seizure-related injury and aspiration by positioning patient in a lateral decubitus position, maintaining raised positioning of padded side rails, and not forcing a padded tongue blade to the back of the throat
• Monitor fetal and maternal status and manage complications, as ordered; after patient stabilization, provide emotional support and educate about treatment risks and benefits
• Follow facility pre- and posttreatment protocols for vaginal or cesarean delivery within 24 hours or for evaluation of retained products of conception (RPOC; i.e., placental tissue that is not expelled from the uterus during delivery) if eclampsia manifests during the postpartum period; reinforce pre- and posttreatment education and verify completion of facility informed consent documents
•Corticosteroids may be ordered before delivery to improve fetal lung maturity, but delivery is not usually delayed based on level of fetal maturity