A Case Study

Presented to the Faculty of the Tarlac State University

College of Science, Department of Nursing

SPONTANEOUS VAGINAL
DELIVERY FOR
PREECLAMPSIA WITH
SEVERE FEATURES
BSN 2-3 (Group 4)
INTRODUCTION
Preeclampsia is a significant hypertensive disorder that occurs during pregnancy,
impacting blood pressure and organ function. Early detection and management are
vital to avoid serious outcomes for both mother and baby to prevent progression to
eclampsia, which involves seizures. It typically develops after 20 weeks of
gestation, most commonly in the third trimester and when it manifests before 34
weeks, it is classified as early-onset preeclampsia (American College of Obstetrics
and Gynecologists, 2023). This case study presents G2P2 (2002), at 39 weeks
and 4 days of gestation, presenting in labor with a cephalic fetal position and
diagnosed with preeclampsia with severe features. This condition is characterized
by elevated blood pressure (≥140/90 mmHg), the presence of protein in the urine
(proteinuria), or liver impairment. Signs and symptoms vary in severity and can
develop gradually or quickly, often include persistent hedaches,
vision disturbances like blurriness or sensitivity to light, and swelling due to fluid retention.
The exact cause of preeclampsia is still unknown, yet it is mainly associated with
atypical placental growth and maternal vascular issues. Risk factors for preeclampsia in
pregnancy are under 15 and over 35 years old, personal history of preeclampsia, chronic
hypertension, family history of preeclampsia, diabetes, chronic kidney disease (WHO,
2025).

Globally, preeclampsia remains a leading cause of maternal and neonatal mortality.

Preeclampsia affects 2–8% of pregnancies worldwide, contributing to 46,000 maternal
deaths and 500,000 fetal or neonatal deaths annually. The burden is particularly high in
low-resource settings, where access to timely intervention remains a challenge (WHO,
2025).

Data from the Philippine Health Statistics (2017) indicate that preeclampsia and
eclampsia account for up to 30% of maternal deaths, highlighting the urgent need for
improved prenatal care and early detection strategies.
 GENERAL OBJECTIVE
This case study is essential for deepening our understanding of maternal
health complications and improving patient care outcomes. By analyzing
this case, we gain firsthand experience in identifying clinical signs,
understanding pathophysiological processes, and applying evidence-
based interventions. With interdisciplinary collaboration and patient-
centered care, student nurses will be equipped to contribute to improve
healthcare strategies and reducing complications associated with pre-
eclampsia.
SPECIFIC OBJECTIVES
1. To assess the patient’s condition thoroughly through
comprehensive health history, 13 areas, including
diagnostic test and laboratory results.
2. To formulate appropriate nursing diagnosis based on
clinical findings, laboratory results, and patient
symptoms.
3. To plan appropriate interventions by developing a care
plan that prioritizes maternal safety, including blood
pressure control and seizure prevention strategies.
SPECIFIC OBJECTIVES
4. To implement appropriate nursing interventions such as
medication administration, maternal monitoring, patient
education on the condition, and rendering holistic care.
5. To evaluate the effectiveness of nursing interventions by
monitoring maternal outcomes and assessing treatment
response.
6. To document patient progress and clinical findings
accurately, ensuring continuity of care, interdisciplinary
collaboration, and adherence to healthcare protocols for
improved maternal health.
Name: M.A.B.P Educational Attainment: College undergraduate

Age: 28 years old Address: Brgy. Balite, Pura, Tarlac

Chief Complaint: Labor pain
Sex: Female
Admitting Diagnosis: G2P1 (1001) Pregnancy Uterine 39 4/7
Civil Status: Single
weeks age of gestation, cephalic in labor, gestational
Occupation: Vendor of vegetables
hypertension, obesity
Date of Birth: May 16, 1996 Final Diagnosis: G2P2 (2002) Pregnancy Uterine, Delivered
Nationality: Filipino Term, Cephalic, live baby boy with APGAR score 9,9, Birth
Religion: Roman Catholic Weight 2.4 SGA by Spontaneous Vaginal Delivery with Right

Role/Position in the Family: Mother Mediolateral episiotomy and repair under local anesthesia,
preeclampsia with severe features.

NURSING PROCESS
ENVIRONMENTAL STATUS
Patient MA.B.P. is currently residing in Barangay Balite, Pura, Tarlac, along

with her live in partner and their 5-year-old daughter in a single-story

residence consisting of two bedrooms, a kitchen, and three windows. The

patient has reported that the air quality within the home is adequate, with

sufficient exposure to natural light and adequate ventilation. The residences

in the vicinity are closely situated. Waste management is systematically

handled, with garbage being collected every Wednesday and no waste

burning conducted.
 LIFESTYLE
Before her pregnancy, the patient worked daily as a vegetable vendor along Ramos Street in Tarlac

City. During her pregnancy, she discontinued her business to remain at home, prioritizing bed rest

and dedicating sufficient time and care to her pregnancy. Before conception, she weighed 80 kg

and a height of 157 cm, but during pregnancy, her weight increased to 98 kg, exceeding the healthy

gestational weight gain. She consumes three meals a day, enjoys vegetables especially broccoli,

cabbage, and carrot, fruits especially banana and oranges and she typically eats 1.5 cups of rice per

meal. She drinks 8 to 10 glasses per day. Additionally, she takes multivitamins, including ferrous and

calcium supplements, to support her health during pregnancy.

 LIFESTYLE
The patient has experienced sleep disturbances, frequently waking between 2:00

and 3:00 am due to nocturia, occuring five times per night. As a result, her total sleep

duration has averaged approximately five hours per night, with her usual waking

time at 7:00 am. She enjoys cooking and eating soupy dishes such as pork sinigang,

vegetable soup (sinabawang gulay), and chicken tinola with malunggay. After

completing her household chores, she takes time to rest. She finds relaxation in

watching television and taking leisurely walks both outside and inside of their home.
GENOGRAM
HISTORY OF PAST ILLNESS
Patient MA.B.P. has completed all her prenatal visits for this second pregnancy. At 16
weeks of gestation, she was diagnosed with preeclampsia, with blood pressure
ranging between 150/100 mmHg and 160/100 mmHg. She has no known allergies to
medications, food, or beverages. During her first pregnancy, she was also
diagnosed with preeclampsia. the patient reported being hospitalized at the age of
19 in a hospital in Gerona, Tarlac. She stated that the attending physician diagnosed
her with a urinary tract infection (UTI), for which she was admitted for two days
before being discharged. In addition, she experiences dysmenorrhea during
menstruation, with a reported pain scale of 6/10.
HISTORY OF PRESENT ILLNESS
Patient MA.B.P., a 28-year-old female, at 39 4/7 weeks age of
gestation, with an obstetric score of G2, T2, P0, A0, L2. On the evening
of May 1, 2025, between 10:00 PM and 12:00 AM, the patient stated
that she was experiencing labor pain characterized by sharp discomfort
in the epigastric area. The contractions were occurring at four-minute
intervals, with the pain intensity rated at 8/10. Alongside these
symptoms, the patient experienced two episodes of watery vomiting,
nausea, dizziness, visual disturbances, difficulty of breathing, and red
spotting.
HISTORY OF PRESENT ILLNESS
Upon admission, her chief complaint remained, which is labor pain.
At 7:38 AM on May 2, 2025, the patient’s vital signs were taken as
follows:
Blood pressure: 150/100 mmHg
Pulse rate: 95 beats per minute
Respiration: 20 cycle per minut
Temperature: 36.5°C
SpO2: 98%
HISTORY OF PRESENT ILLNESS
At 8:30 AM, prior to the internal examination, the blood pressure showed a
further elevation to 160/100 mmHg. The internal examination revealed that the
cervix was 5 cm dilated and 50% effaced, with the fetus in a cephalic
presentation at station -2, and the amniotic sac intact with a positive bag of
water. Patient MA.B.P. underwent spontaneous vaginal delivery with right
mediolateral episiotomy and repair under local anesthesia, delivered to a live
baby boy. After placental delivery, another blood pressure reading was taken,
showing persistent at 160/100 mmHg. As she was transferred via a stretcher,
another measurement recorded blood pressure at 140/110 mmHg, and the
patient was then transferred to the OB ward awake and alert.
 13 AREAS OF ASSESSMENT
DATE
AREAS FINDINGS ANALYSIS
PERFORMED
The student nurse assessed Abnormal findings noted.
05/02/25 SENSORY the patient's near vision Pupils are within normal
STATUS using a handheld Snellen limits; however, the
chart. The patient, in a semi- presence of visual
Fowler’s position, could not disturbance may indicate
Sense of Sight
read beyond the 20/70 line neurological involvement
and reported hazy, unclear commonly associated with
letters and blurred vision of preeclampsia.
nearby objects. Although
her pupils were PERRLA and
extraocular movements
were intact, the findings
indicated blurred vision.
 13 AREAS OF ASSESSMENT
DATE
AREAS FINDINGS ANALYSIS
PERFORMED

05/02/25 SENSORY The student nurse assessed Slightly abnormal findings are
the patient’s sense of smell noted.
STATUS The patient showed delayed
using a familiar scent — a
citrus-scented item. The recognition of a familiar citrus
Sense of Smell scent and reported slight
patient exhibited delayed
difficulty perceiving it. This
recognition of the scent and
may be attributed to her
reported slight difficulty
current difficulty of breathing,
perceiving it, which may be which could impair airflow
associated with her current through the nasal passages
difficulty of breathing. and affect olfactory
perception.
 13 AREAS OF ASSESSMENT
DATE
AREAS FINDINGS ANALYSIS
PERFORMED
Abnormal findings noted.
05/02/25 RESPIRATORY The patient showcases elevated,
STATUS labored Respiratory rate (26 Cpm)
and an Oxygen Saturation slightly
below normal limits (93%) upon
assessment. Irregular,
rapid/shallow breathing was
observed. The patient may be
experiencing fluid overload or
respiratory distress, making it
difficult for oxygen to pass
through the lungs causing
difficulties in breathing.
 13 AREAS OF ASSESSMENT
DATE
AREAS FINDINGS ANALYSIS
PERFORMED
Abnormal findings noted.
05/02/25 RESPIRATORY The patient showcases elevated,
STATUS labored Respiratory rate (26 Cpm)
and an Oxygen Saturation slightly
below normal limits (93%) upon
assessment. Irregular,
rapid/shallow breathing was
observed. The patient may be
experiencing fluid overload or
respiratory distress, making it
Upon assessment, notable breath difficult for oxygen to pass
sounds such as wheezing were heard through the lungs causing
upon auscultation. A nasal cannula difficulties in breathing.
was inserted at 10:12 a.m.
 13 AREAS OF ASSESSMENT
DATE
AREAS FINDINGS ANALYSIS
PERFORMED

05/02/25 CIRCULATORY With abnormal findings

9:38 AM noted.
STATUS
The patient showcased
irregular/elevated
cardiac rates as high as
130 bpm, and a blood
pressure reaching the
max of 160/100 mmHg.
 13 AREAS OF ASSESSMENT
DATE
AREAS FINDINGS ANALYSIS
PERFORMED

05/02/25 CIRCULATORY With abnormal findings

12:09 PM noted.
STATUS
The patient showcased
irregular/elevated
cardiac rates as high as
130 bpm, and a blood
pressure reaching the
max of 160/100 mmHg.
 13 AREAS OF ASSESSMENT
DATE
AREAS FINDINGS ANALYSIS
PERFORMED

05/02/25 CIRCULATORY With abnormal findings

2:28 PM noted.
STATUS
The patient showcased
irregular/elevated
The heart rate was measured for one full minute, with the blood
cardiac rates as high as
pressure via a manual sphygmomanometer, and the capillary refill
via pressing of the fingernail.
130 bpm, and a blood
pressure reaching the
max of 160/100 mmHg.

The heart rate was measured for one full

minute, with the blood pressure via a
manual sphygmomanometer, and the
capillary refill via pressing of the fingernail.
 13 AREAS OF ASSESSMENT
DATE
AREAS FINDINGS ANALYSIS
PERFORMED
The patient is 157 cm tall, weighs 98 kg, Abnormal findings noted. The
05/02/25 NUTRITIONAL and has a BMI of 39.5. She gained 18 kg patient's BMI of 39.5 indicates
over 9 months, increasing from 80 kg to obesity, a known risk factor for
STATUS 98 kg during pregnancy. Before preeclampsia. Despite this, the
pregnancy, she had no dietary patient has made positive dietary
restrictions and often ate sweets and adjustments during pregnancy,
high-calorie foods. After becoming including increased vegetable and
pregnant, she shifted to a healthier diet fruit intake, meal frequency control,
focused on fruits and vegetables, and improved hydration.
eating three times a day and avoiding Additionally, Irregular weight gain
sugary foods, though she occasionally was observed, accumulating 18 Kg
gave in to cravings in the second (from 80 Kg to 98 Kg) during the
trimester. To manage hunger and span of pregnancy, more than the
energy, she began eating five small recommended range for the
meals daily and drinks 1–2 liters of patient’s weight class, indicating
water per day for hydration. risk for Preeclampsia.
 13 AREAS OF ASSESSMENT
DATE
AREAS FINDINGS ANALYSIS
PERFORMED
During early pregnancy, the patient Abnormal findings are noted, with
05/02/25 ELIMINATION experienced normal frequent decreased output indicating
urination (6–8 times/day) due to oliguria, a common finding in
STATUS hormonal changes. However, by the preeclampsia due to reduced
third trimester, urinary frequency kidney perfusion. Additionally,
decreased to 3–4 times/day with pregnancy may weaken the
reduced volume, indicating possible bladder muscle making it harder to
oliguria. After delivery, a catheter fully empty it when urinating
inserted at 9:59 a.m. drained only leading to reduced urine output.
about 110 mL of urine over 4.5 hours
(24.4 mL/hour), further suggesting Bowel elimination is normal, with
decreased urinary output. The regular brown stool and no noted
patient reports regular bowel abnormalities.
movements (1–2 times/day) with
brown stool and no signs of diarrhea
or constipation.
 13 AREAS OF ASSESSMENT
DATE
AREAS FINDINGS ANALYSIS
PERFORMED
Patient MA.B.P reports going to Slightly abnormal findings are
05/02/25 SLEEP - REST sleep at 10:00 p.m. but often noted; patient’s sleep is
PATTERN wakes between 2:00 to 3:00 fragmented and below the
a.m. to urinate, then sleeps recommended duration, which
again until around 7:00 a.m. may lead to mild fatigue.
She describes her sleep as
light and frequently
interrupted, with an average of
5 to 6 hours of actual rest. She
does not nap during the day
and feels mildly tired upon
waking.
 13 AREAS OF ASSESSMENT
DATE
AREAS FINDINGS ANALYSIS
PERFORMED

The patient’s skin is smooth, Slightly abnormal findings

05/02/25 STATE OF SKIN are noted; the presence of
pale, and warm, with normal
AND turgor and no lesions or bilateral pedal non-pitting
APPENDAGES redness. Bilateral lower edema and pallor may be
extremities exhibit non-pitting related to preeclampsia and
edema over the ankles and altered circulatory status.
dorsum of the feet. She is febrile
at assessment. Hair is black and
dry; nails are intact with a
grayish-white hue, and there is
no digital clubbing.
LABORATORY AND DIAGNOSTIC PROCEDURE

URINALYSIS:
LABORATORY AND DIAGNOSTIC PROCEDURE

HEMATOLOGY:
LABORATORY AND DIAGNOSTIC PROCEDURE

BLOOD CHEMISTRY:
LABORATORY AND DIAGNOSTIC PROCEDURE

ABO/RH TYPING:
LABORATORY AND DIAGNOSTIC PROCEDURE

HBA1C
HOLCLINE 100:
LABORATORY AND DIAGNOSTIC PROCEDURE

ULTRASOUND
REPORT:
Client Based Pathophysiology
Client Based Pathophysiology
 Client Based
Pathophysiology
 PRIORITIZATION OF NURSING DIAGNOSIS

In preeclampsia, hypertension and vascular resistance increase cardiac workload, reducing effective blood flow
to vital organs. Maslow’s Hierarchy and the ABC framework (Airway, Breathing, Circulation) prioritize circulatory
DECREASED CARDIAC OUTPUT
function first, as compromised cardiac output can lead to end-organ damage, stroke, or heart failure. Stabilizing
cardiac function prevents further deterioration.

Preeclampsia causes fluid retention, leading to either intravascular dehydration or fluid overload (edema,
pulmonary congestion). Under Maslow’s Hierarchy, maintaining fluid homeostasis supports circulatory stability.
FLUID VOLUME IMBALANCE
Addressing this early ensures proper circulation, prevents complications like kidney dysfunction, and optimizes
perfusion. If fluid balance is left unmanaged, it can exacerbate cardiac strain and worsen tissue perfusion.

Once circulation and fluid balance are stabilized, the next priority is oxygen and nutrient delivery to critical organs.
Florence Nightingale’s Environmental Theory reinforces the importance of oxygen and nutrient delivery to critical organs
INEFFECTIVE TISSUE PERFUSION
(brain, kidneys, placenta). Maintaining a stable internal environment to support healing, which directly applies to
vasospasm-induced perfusion deficits in preeclampsia.

Prioritization follows Maslow’s Hierarchy, where physiological needs take precedence, but pain is secondary to life-
threatening concerns like circulation and oxygenation. Using Melzack and Wall's Gate Control Theory, pain is influenced
ACUTE PAIN by sensory and emotional factors. In preeclampsia, headaches and abdominal pain stem from hypertension and
vasoconstriction. Effective pain management prevents additional stress responses that can worsen cardiovascular strain.
Roy’s Adaptation Model highlights the importance of adaptive pain interventions to support patient stability and recovery.

Ranked last because immediate physiological threats must be stabilized first before psychological concerns are
addressed. Peplau’s Interpersonal Relations Theory reinforces that anxiety is best managed through therapeutic
communication and patient education, fostering trust and emotional security. Lazarus and Folkman’s Stress and Coping
ANXIETY
Theory emphasizes the role of effective coping mechanisms in preventing heightened sympathetic stimulation, which
could elevate blood pressure. Managing anxiety enhances patient engagement and adherence to treatment, contributing
to long-term well-being.
 NCP 1: DECREASED CARDIAC OUTPUT

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Decreased cardiac Within 6 hours of

Subjective: Independent: This position improves After 6 hours of rendering
output related to rendering proper nursing
“Medyo nahihirapan ako sa uteroplacental blood flow proper nursing interventions, the
decreased venous interventions, the patient
paghinga at parang bumibilis Assist the mother lying in and reduces pressure on patient’s blood pressure
return. will display
ang pag tibok ng puso ko” as the left lateral position. the inferior vena cava, stabilizes 130/90 and edema
hemodynamic stability,
verbalized by the patient enhancing cardiac output reduces.
Scientific explanation: with blood pressure
and fetal oxygenation.
A decrease in cardiac closer to normal range.
output from reduced
Objective Cues:
venous return
(+) Edema: Swelling in feet
happens when less
Prolonged capillary refill These are early signs of
blood returns to the
(>2 seconds). Instruct the patient to severe preeclampsia or
heart, lowering
Decreased urine output report symptoms such as impending eclampsia and
ventricular filling and
(<30 mL/hr). headache, visual require prompt
stroke volume. This
Visual disturbance changes, or epigastric intervention to prevent
reduces myocardial
Pre-Pregnancy 80 kg pain immediately. complications.
stretch and
Pregnancy weight:99kg
contraction strength,
Proteinuria: positive
leading to less blood
pumped out. As a
Vital Signs: These techniques help
result, systemic
BP:150/100mmHg Demonstrate relaxation reduce sympathetic
perfusion and oxygen
PR: 95 beats per minute techniques such as deep nervous system activity,
delivery drop, causing
RR: 20 cycle per minute breathing exercises. thereby decreasing blood
hypotension. The
T: 36.5°C pressure and anxiety.
body compensates
O2 Sat.:94%
with an increased
heart rate.
NCP 1: DEACREASED CARDIAC OUTPUT

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Reducing external stimuli

Provide a quiet and dim helps prevent seizure
environment. activity and decreases
blood pressure elevation.

Assist the patient with Regular movement

frequent position changes improves circulation,
such as turning side to prevents pressure
side every 2 hours or injuries, and enhances
elevating the legs with maternal comfort during
pillows under legs labor.

Frequent monitoring is
essential to detect rapid
changes that may signal
Perform frequent worsening preeclampsia
monitoring of vital signs, or impending
particularly blood complications.
pressure, every 15–30
minutes or as indicated.
NCP 1: DEACREASED CARDIAC OUTPUT

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Dependent: Methyldopa is a centrally

acting antihypertensive
Administer prescribed that lowers systemic
antihypertensive vascular resistance,
medications.such as decreasing afterload and
Methyldopa PO 1 tablet supporting cardiac output
(250 mg) once a day in chronic hypertension or
mild pre-eclampsia.

Administer Hydralazine IV. Hydralazine is a direct

STAT every 15 minutes. vasodilator that rapidly
decreases BP, helping
reduce cardiac strain and
improve output.

Collaborative:

Coordinate with the

physician/OB team for To ensure timely
ongoing evaluation and interventions (e.g., fluid
care decisions. management, medication
changes, delivery
planning) based on the
evolving maternal and
fetal condition.
 NCP 2: FLUID VOLUME IMBALANCE

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Deficient Fluid Volume Within 6 hours of Independent: After 6 hours of

Related to Plasma Rendering proper nursing rendering proper nursing
Subjective: protein loss and interventions. Educate the laboring Early symptom reporting interventions, the patient
Decreased plasma mother (as condition allows prompt demonstrates improved
“Medyo namamaga po colloid osmotic The patient will
allows) to report intervention for fluid balance:reduced
ang dalawang paa ko pressure demonstrate improved
symptoms such as hypovolemia and edema,normal urine
nurse” as verbalized by fluid balance, reduced
dizziness, palpitations, hypotension during output.
the patient. edema, and adequate
Scientific explanation: weakness, or vision labor.
urine output.
Preeclampsia causes changes immediately.
Objective Cues: endothelial damage,
Edema (non- pitting) increasing vascular Instruct the mother to To prevent orthostatic
Decreased urine permeability and avoid sudden position hypotension or syncope
output (<30 mL/hr). leading to plasma changes (e.g., sitting due to low circulating
(+) Proteinuria protein loss into the up quickly) during volume.
interstitial space. This
delayed capillary labor and postpartum
reduces blood
refill (3 seconds) transition.
protein levels and
lowers plasma
Vital Signs: Demonstrate breathing Reduces Maternal
colloid osmotic
BP:150/100mmHg pressure, impairing and relaxation exertion, conserving
PR: 95 beats per minute fluid reabsorption into techniques that help fluid and cardiovascular
RR: 20 cycle per minute the bloodstream and conserve energy and energy in a hypovolemic
T: 36.5°C resulting in oxygen during state.
O2 Sat.: 94% decreased fluid contractions such as
volume. deep breathing
exercises
NCP 2: FLUID VOLUME IMBALANCE

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Provide a calm, low- Promotes venous

stimulation environment return, reduces
and encourage lateral uterine pressure on
positioning (especially major vessels, and
left lateral). supports blood flow
to the placenta.

Assist the patient with

perineal care, cold Conserves energy
compresses, or comfort and provides physical
positioning as labor support during a state
progresses. of compromised fluid
volume.

Perform ongoing non-

invasive monitoring (skin Direct observation
turgor, mucous allows early detection
membranes, capillary of worsening fluid
refill, and vital signs every deficit or
15–30 minutes or per hemodynamic
protocol). instability.
NCP 2: FLUID VOLUME IMBALANCE

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Dependent Interventions IV fluids help maintain

: circulating volume,
Administer IV fluids such especially important
as D5LRS 1L 10-15 when plasma proteins
gtts/min as prescribed to are low and fluid
restore fluid volume. shifts out of the
vascular space.

Controlling high BP
Administer Methyldopa reduces the risk of
PO 1 tablet (250mg) once further endothelial
a day and Hydralazine IV damage and capillary
5mg as ordered to leakage that worsen
manage hypertension fluid loss.

Collaborative: To ensure timely

interventions (e.g.,
Coordinate with the fluid management,
physician/OB team for medication changes,
ongoing evaluation and delivery planning)
care decisions. based on the evolving
maternal and fetal
condition.
 NCP 3. INEFFECTIVE TISSUE PERFUSION

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Ineffective tissue
Subjective: Within 6 hours of Independent: After 6 hours of rendering
perfusion related to
“Naghihina po ako at rendering proper nursing interventions, the
vasospasm and
pagod na pagod” as nursing interventions Educate the patient and Early recognition of signs patient demonstrates improved
endothelial
verbalized by the the patient will show support persons about the indicating worsening perfusion: stable blood
dysfunction secondary
patient improved tissue importance of reporting vasospasm or cerebral pressure and normal urine
to preeclampsia.
perfusion, symptoms like chest pain, ischemia helps prevent output.
Objective Cues: demonstrated by sudden headache, visual serious complications.
stable blood pressure changes, or numbness
Edema (non - pitting) Scientific Explanation: and adequate urine immediately.
Difficulty of breathing Ineffective tissue output.
Headache perfusion results from low
Decreased urine output cardiac output and high Instruct the mother to This position improves
(<30 mL per hour) vascular resistance, remain in a lateral uteroplacental blood flow
reducing oxygen delivery
(+) Proteinuria (preferably left lateral) and reduces pressure on
to organs.
Visual disturbance Vasoconstriction worsens
position during labor. major blood vessels,
blood flow, risking optimizing tissue
Vital Signs: ischemia, kidney failure, perfusion.
BP: 150/100mmHg and neurological issues
PR: 95 beats per minute like stroke. In pregnancy, it
RR: 20 cycle per minute can cause placental Demonstrate slow, Decreases vasospasm by
insufficiency, fetal
T: 36.5°C controlled breathing lowering stress-induced
distress, and growth
O2 Sat.: 94% techniques to help vasoconstriction.
restriction. If untreated, it
may lead to multi-organ manage pain and reduce
failure, HELLP syndrome, sympathetic nervous
or DIC. system stimulation.
 NCP 3: INEFFECTIVE TISSUE PERFUSION

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Provide a calm, dimly lit Helps prevent further

environment with endothelial irritation and
minimal stimuli. vasospasm triggered by
sensory overload.

Assist the patient with Prevents sudden

gentle repositioning and changes in blood
comfort measures pressure that could
during labor such as worsen tissue
placing pillows under perfusion.
the knees or back.

Perform frequent Continuous monitoring

assessment of maternal detects early signs of
vital signs (BP, HR, deteriorating perfusion.
respiratory rate, oxygen
saturation) and fetal
monitoring every 15
minutes or as ordered.
 NCP 3: INEFFECTIVE TISSUE PERFUSION

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Dependent:
Administer prescribed These medications help
antihypertensive reduce vasospasm and
medications such as lower blood pressure,
Methyldopa oral 1 tablet improving tissue
(250 mg) once a day perfusion.

Administer oxygen Supplemental oxygen

therapy as ordered to can improve oxygen
enhance tissue delivery to hypoperfused
oxygenation. tissues.

Collaborative: To ensure timely

Coordinate with the interventions (e.g., fluid
physician/OB team for management, medication
ongoing evaluation and changes, delivery
care decisions. planning) based on the
evolving maternal and
fetal condition.
DRUG STUDY
Name of the Drug

Generic Name:
Methyldopa

Brand Name:
Aldomet

Classification:
Antihypertensives
DRUG STUDY
Route, Dosage, & Frequency

Route:
Oral / PO

Dosage:
1 tablet (250 mg)

Frequency:
Once a day
DRUG STUDY
Mechanism of Action
It is converted to methyl
norepinephrine centrally to
decrease the adrenergic outflow
by alpha-2 agonistic action from
the central nervous system,
leading to reduced total
peripheral resistance and
decreased systemic blood
pressure, Alpha-2 agonistic
activity does not affect cardiac
output of renal blood flow.
DRUG STUDY
Indications
treatment for high blood
pressure
management of
hypertensive crises
DRUG STUDY
Contraindications
hypersensitivity
active hepatic disease
liver problems caused by
previous methyldopa
therapy
DRUG STUDY
Side Effects

lightheadedness
pale or yellow skin
dark colored urine
fever
confusion
weakness
involuntary muscle
movements
nausea and vomiting
shortness of breath
tachycardia
DRUG STUDY
Nursing Responsibilities
If administered during childbirth,
monitor for maternal seizures or
decreased consciousness
Monitor the patient for involuntary
movements, discontinue the medication
if they occur
Instruct the patient to avoid sudden
position changes
Inform the patient that her urine may
turn dark
Encourage the patient to suck on candy,
ice chips, or chew gum to relieve dry
mouth
DRUG STUDY
Name of the Drug

Generic Name:
Hydralazine
Brand Name:
Aprezobas
Classification:
Direct Vasodilator
DRUG STUDY
Route, Dosage, & Frequency

Route:
IV

Dosage:
5 mg

Frequency:
STAT then every 15
minutes
DRUG STUDY
Mechanism of Action

Hydralazine is a direct-acting
vasodilator which acts
predominantly on the arterioles. The
exact mechanism of action is
unknown, but it is thought to exert its
vasodilating effect through direct
relaxation of vascular smooth muscle
by inhibition of Ca release from the
sarcoplasmic reticulum and
inhibition of myosin phosphorylation
in the arterial smooth muscle cells.
DRUG STUDY
Indications
severe essential
hypertension
chronic hypertension
hypertensive crises
congestive heart failure
DRUG STUDY
Contraindications
hypersensitivity
coronary artery disease
mitral valve rheumatic heart
disease
DRUG STUDY
Side Effects

hypotension
palpitations
conjunctivitis
tachycardia
headache
nausea and vomiting
hepatotoxicity
dyspnea
dysurea
nasal congestion
peripheral edema
DRUG STUDY
Nursing Responsibilities
Observe for signs of excessive
vasodilation such as flushing or severe
hypotension
Institute fall risk precautions according
to hospital protocol
DRUG STUDY
Name of the Drug

Generic Name:
Magnesium Sulfate

Brand Name:
Magnesium Sulfate

Classification:
Anticonvulsants
DRUG STUDY
Route, Dosage, & Frequency

Route:
SIVP

Dosage:
4g

Frequency:
once
DRUG STUDY
Mechanism of Action
Magnesium sulfate is essential for the
activity of many enzyme systems and plays
an important role with regard to
neurochemical transmission and muscular
excitability. Magnesium sulfate reduces
striated muscle contractions and blocks
peripheral neuromuscular transmission by
reducing acetylcholine release at the
myoneural junction. Additionally,
Magnesium inhibits Ca2+ influx through
dihydropyridine-sensitive, voltage-
dependent channels. This accounts for
much of its relaxant action on vascular
smooth muscle.
DRUG STUDY
Indications
hypomagnesemia
toxemia of pregnancy
preterm labor (as
tocolytic)
prevention & treatment of
seizures associated with
eclampsia
DRUG STUDY
Contraindications
hypersensitivity
hypermagnesemia
hypercalcemia
administration 2 hours before
delivey of mother with toxemia
myocardial damage
diabetic coma
DRUG STUDY
Side Effects
circulatory collapse
respiratory paralysis
hypothermia
pulmonary edema
poor reflexes
drowsiness
increased sweating
visual changes
breathing difficulties
flushing
headache
DRUG STUDY
Nursing Responsibilities
Administer the medication slowly to
prevent sudden drop in blood pressure
Assess the patient’s vital signs
especially the respiration and blood
pressure
Assess the patient’s deep tendon
reflexes (loss of dtr is an early sign of
toxicity)
DRUG STUDY
Name of the Drug
Generic Name:
Tranexamic Acid

Brand Name:
Furenex

Classification:
Antifibrinolytics
DRUG STUDY
Route, Dosage, & Frequency

Route:
IVP

Dosage:
1g

Frequency:
STAT
DRUG STUDY
Mechanism of Action
Tranexamic acid competitively and
reversibly inhibits the activation of
plasminogen via binding at several
distinct sites, including four or five low-
affinity sites and one high-affinity site,
the latter of which is involved in its
binding to fibrin. The binding of
plasminogen to fibrin induces
fibrinolysis - by occupying the
necessary binding sites tranexamic
acid prevents this dissolution of fibrin,
thereby stabilizing the clot and
preventing hemorrhage.
DRUG STUDY
Indications
bleeding
heavy menstrual bleeding
hereditary angioedema
DRUG STUDY
Contraindications
hypersensitivity
active thromboembolic disease
history of thromboembolism
history of convulsions
acquired disturbances of color
vision
DRUG STUDY
Side Effects
puffiness around face, eyes, lips,
tongue
hematuria
cloudy urine
pain during urination
changes in vision
chest pain
confusion
difficulty swallowing
disturbed color perception
orthostatic hypotension
DRUG STUDY
Nursing Responsibilities
Administer the IV push slowly to
prevent sudden drop in patient’s blood
pressure
Instruct the patient to avoid doing
anything dangerous as this drug will
make you feel dizzy
Instruct the patient to avoid sudden
position changes
DRUG STUDY
Name of the Drug

Generic Name:
Oxytocin
Brand Name:
Ambtocyn
Classification:
Uterine stimulator
DRUG STUDY
Route, Dosage, & Frequency

Route:
IM

Dosage:
10 units
DRUG STUDY
Mechanism of Action

Oxytocin, produced in the hypothalamus

and stored in the posterior pituitary, plays
a vital role in labor by stimulating uterine
contractions through a positive feedback
loop. As pregnancy progresses, increased
oxytocin receptors in the myometrium
enhance sensitivity, triggering calcium
release to strengthen contractions. Fetal
pressure on the cervix further stimulates
oxytocin production, continuing until
childbirth is complete. Synthetic oxytocin
mimics this process to induce labor when
medically necessary.
DRUG STUDY
Indications
incomplete abortion
inevitable abortion
postpartum bleeding
labor induction
DRUG STUDY
Contraindications
hypersensitivity
significant cephalopelvic
disproportion
unfavorable fetal presentation
or position
obstetric emergencies that
favor surgery
contraindicated vaginal delivery
fetal distress
hyperactive uterus
DRUG STUDY
Side Effects
slow or fast heart rate
arrhythmias
permanent CNS damage (neonate)
neonatal jaundice
low APGAR score
uteroplacental hypoperfusion
inadequate fetal oxygen levels
severe decreases in maternal blood
pressure
DRUG STUDY
Nursing Responsibilities
Administer the medication
intramuscularly as prescribed
If administered during childbirth,
monitor for maternal seizures or
decreased consciousness
 EVALUATION
a.General Condition

As a result of the prescribed medications, the patient's general condition has improved
significantly. She appears to be properly hydrated after receiving intravenous fluids.
Furthermore, the patient clearly understands the health education delivered on
postpartum care. The student nurses have effectively trained her on a variety of topics,
including postpartum nutrition, perineal care, breastfeeding, and safe activity.
 Generic Name: Methyldopa

METHOD APPROACH
Mechanism of Action: Alpha-2 agonistic action reduces adrenergic outflow,
peripheral resistance, and systemic blood pressure by converting it to methyl
norepinephrine, without affecting cardiac output or renal blood flow.
Route: Oral/PO
Dosage: 1 tablet (250mg)
Frequency: Once a day

Generic Name: Hydralazine

Mechanism of Action: Hydralazine is a direct-acting vasodilator which acts
predominantly on the arterioles.
Route: IV
Dosage: 5 mg (maximum 20 mg)
Frequency: STAT then every 15 minutes

Generic Name: Magnesium Sulfate

MEDICATIONS
Mechanism of Action: Magnesium sulfate is essential for the activity of many
enzyme systems and plays an important role with regard to neurochemical
transmission and muscular excitability.
Route: SIVP
Dosage: 4g
Frequency: STAT
METHOD APPROACH Generic Name: Tranexamic acid
Mechanism of Action: Tranexamic acid inhibits plasminogen activation through
binding at multiple sites, including low-affinity and high-affinity sites, including one
involved in fibrin binding.
Route:IV
Dosage: 1g
Frequency:STAT

Generic Name: Oxytocin

Mechanism of Action: Oxytocin, produced in the hypothalamus, stimulates
uterine contractions through a positive feedback loop, stored in the posterior
pituitary, and released in pulses during childbirth.
Route: IM

MEDICATIONS Dosage:10units
METHOD APPROACH
Patient MA.BP was advised to walk slowly and practice
deep breathing exercises. Walking promotes
peristalsis and improves the patient's mood. Breathing
with the diaphragm is also recommended, as it allows
for torso stabilization and correct core muscular
contraction. In addition, she should undertake active
and passive range of motion (ROM) exercises on a
EXERCISE regular basis. These workouts improve blood
circulation and help avoid joint stiffness. They can be
done with the help of a nurse or their guardian. These
activities will prepare the patient's body for a return to
normal physical activity while also lowering the chance
of further difficulties. Furthermore, these can boost
overall well-being.
METHOD APPROACH 1.Sit on a pillow or padded ring.
2.Cool the area with an ice pack or place a chilled
witch hazel pad between a sanitary napkin and the
area between your vaginal opening and anus
(perineum).
3.Use a squeeze bottle to pour warm water over the
perineum as you're passing urine.
4.Sit in a warm bath just deep enough to cover your
buttocks and hips for five minutes. Use cold water if

TREATMENT you find it more soothing.

5.Apply an over-the-counter hemorrhoid cream or
suppository containing hydrocortisone. Use pads
containing witch hazel or a numbing agent.
6.Soak your anal area in plain warm water for 10 to 15
minutes two to three times a day.
7.Take an over-the-counter pain reliever.
8.Using a stool softener or laxative to prevent
constipation.
METHOD APPROACH 1.Educated the patient and her significant other about
maintaining a low fowler’s position to promote blood
circulation to the perineal area.
2.Provided diversional activities such as watching
movies to distract the patient from the pain.
3.Demonstrated proper relaxation techniques such
as breathing exercises which can help improve the
patient’s mood and reduce inflammation.
HEALTH 4.Educated the patient about the need to turn over in
bed from one side to the other with the help of

TEACHINGS another individual every 2 hours to facilitate blood

flow despite not being able to move due to the pain.
5.Instructed the patient to take a bath every day to
promote comfort and prevent infections.
6.Instructed the patient to wash the perineal gently
using feminine wash solution and rinse with warm
water to avoid urinary infection.
METHOD APPROACH 7.Instructed the patient to have small frequent meals
every 2-3 hours.
8.Instructed the patient to increase the intake of iron-
rich foods by incorporating food like malunggay in
their meals to replace blood loss.
9.Instructed the patient to increase the intake of
foods rich in protein including chicken breast, eggs,

HEALTH tofu, and other meat for fast healing of episiotomy.

10.Instructed the patient to increase the intake of

TEACHINGS
foods rich in fiber including oranges to prevent
constipation.
11.Instructed the patient to increase her fluid intake
for hydration improvement by drinking plenty of
water, at least 8-10 glasses a day, and eating water-
rich food.
12. Instructed the patient to feed the baby with
exclusively breast milk until 6 months at age.
METHOD APPROACH 13.Educated the patient about the benefits of
breastfeeding such as presence of antibodies which
can help the baby to develop a strong immune system
and serves as protection from different illnesses.
14.Demonstrated the various positions in breastfeeding
such as cross cradle, football, and sidelying to promote
comfort.

HEALTH
15.Demonstrated the proper cleaning of the areolar
area using warm water and cotton balls in a circular
motion to prevent exposing the baby to bacteria.

TEACHINGS 16.Demonstrated and instructed the patient to massage

the breast in a gentle circular motion to stimulate
breast production.
17.Educated the patient about the proper latching
techniques such as the chin touching the breast and
the whole nipple being inside the baby’s mouth to
prevent colic.
METHOD APPROACH 18.Instructed the patient to switch from one breast to
another every 1-2 hours.
19.Educated the patient about the management of
nipple soreness: use one finger to lessen the pressure
or pull when removing.
20.Instructed the patient to use a warm compress
before breastfeeding and apply cold compress

HEALTH
afterwards to ease the soreness and engorgement.
21.Demonstrated the different feeding cues to be
observed when the baby is hungry such as rooting and

TEACHINGS sucking.
22.Demonstrated the proper procedure of burping the
baby to prevent aspiration.
23.Instructed the mother to sleep whenever the baby is
asleep in order to recharge her energy.
24.Instructed the patient to let the baby sleep in a
separate crib to prevent suffocation.
25.Instructed the mother to remove all loose bedding.
METHOD APPROACH The patient should return for a check-up six
weeks after giving birth. This follow-up is
necessary to examine maternal well-being in
all aspects, not just physically. The healing
process will also be monitored because the
body is continually reacting after childbirth. If
there are any issues during the first two
weeks after giving birth, she must also go to
FOLLOW UP the hospital for an early follow-up.
METHOD APPROACH
The patient was recommended to follow a
NPO diet prior to labor in order to reduce
sickness and the chance of a cesarean
section. Patient MA.BP was recommended
to eat a soft diet as tolerated after
defecating or passing gas during the
postpartum period. The soft diet, when
tolerated, will serve as a transition from a

DIET NPO diet to a regular diet, allowing food to

be introduced without discomfort. Only soft
and easy-to-eat meals are allowed on this
diet. Otherwise, they are limited or can be
puréed, blended, or boiled to avoid straining
the digestive tract.
METHOD APPROACH Consider the patient's emotional
requirements by spending time listening to
and understanding her sentiments.
Encourage her to open up and demonstrate
that you are actively listening. Offer her
words of support and reassurance. Let her
know you're there to support her and check

EMOTIONAL in on her from time to time. If possible,

volunteer to assist her with even minor tasks.
Refer the patient to other first-time mothers
for comfort, companionship, and advice.
 CONCLUSION
The case study focused on a patient with spontaneous vaginal delivery for
preeclampsia, aiming to understand its pathophysiological mechanisms.
Prioritizing physiological needs, fluid volume imbalance, and ineffective
tissue perfusion, the nursing care plan was developed using Maslow's
hierarchy of needs. This approach effectively managed preeclampsia
complications while contributing to the patient's recovery and postpartum
stabilization. The study underscores the importance of early recognition,
.
timely intervention, and continuous monitoring in managing high-risk
pregnancies and promoting positive outcomes for both mother and child.
 RECOMMENDATIONS
The nursing group has developed a comprehensive plan to address the patient's health status, ensuring
safe recovery, long-term well-being, and prevention of further complications.

1.Prioritize Cardiovascular Monitoring and Blood Pressure Management: Postpartum blood pressure
monitoring is crucial for preeclampsia complications, requiring consistent assessment, timely
medication administration, patient education on monitoring, and awareness of warning signs.
2.Strengthen Fluid and Renal Monitoring: Regularly monitor fluid intake and output to detect fluid
imbalance or oliguria, and recommend regular assessment of serum creatinine, urine protein, and
electrolyte levels.
.
3.Encourage Safe Postpartum Mobilization and Physical Activity: Create personalized activity plans
considering patient's condition and risk factors, encourage early mobilization for circulation, prevent
thromboembolic events, and support recovery, gradually introducing activities with regular assessment
of tolerance and fatigue levels.
 RECOMMENDATIONS
4.Provide Specialized Postpartum Education for Preeclampsia :Provide education on preeclampsia,
postpartum complications, medication adherence, and lifestyle changes, empowering patients to
recognize early signs of recurrence and seek prompt medical care.

5.Promote Holistic Support and Emotional Well-being: Preeclampsia complications can increase
emotional stress, so mental health screening, counseling, and support systems should be integrated to
help with postpartum recovery and newborn care.

6.Advocate for Follow-Up and Long-Term Cardiovascular. Care: Regular follow-up appointments with
obstetricians and primary care providers are recommended to evaluate the patient's recovery and
cardiovascular health, as preeclampsia is a risk factor for future cardiovascular disease.
 RECOMMENDATIONS
To Student Nurse: The case underscores the need for strong clinical
judgment, prioritization, and compassionate care in postpartum care for
women with preeclampsia, enabling student nurses to provide safer
interventions.

To Patients: Mothers recovering from preeclampsia should actively participate

.
in their care, including monitoring, medication, and maintaining a healthy
lifestyle, emotional support, and regular follow-up appointments for long-
term health.
 RECOMMENDATIONS
To Health Care providersHealthcare: professionals should monitor preeclampsia
patients post-delivery, provide comprehensive education, close follow-up, and
resources, and collaborate with interdisciplinary teams and community programs for
improved patient outcomes.

.
DIET

Type of Diet Date Indication/s Nursing Responsibilities

1. Educate the patient on the reason

Indicated for pregnant
for NPO status. Monitor hydration and
patients undergoing
electrolyte balance.
cesarean delivery,
labor with general
2.Prepare for IV fluid and nutrient
anesthesia, or with
support.
complications like
preeclampsia,
NPO 05/02/2025 3.Notify the healthcare provider if the
gastrointestinal issues,
NPO period is prolonged or if the
or risk of aspiration.
patient shows signs of distress,
Allows the GI system
dehydration, or hypoglycemi
to rest and reduces
risk of aspiration
4.Reassess and advocate for diet
during procedures.
progression as soon as it is safe
 Activity/exercise Description

ACTIVITIES
AND EXERCISES Deep Breathing Using the diaphragm when breathing can help engage the core muscles
Exercises without straining the pelvis. Focusing on breathing will also allow the
tension in the body to be alleviated hence, the focus will be on the
present. The central nervous system will become calm as well.

This will help prepare the patient's body to return to walking and other
physical activities while reducing the risk of other complications. Sitting
and walking are the most recommended which will also facilitate good
Gradual ambulation blood circulation and prevent joint stiffness. Walking aids stimulation of
the peristalsis and increases the muscle tone and strength, specifically in
the abdomen and ankles. Aside from that, both can improve the patient's
overall mood and self-esteem.

A healthcare provider or guardian can assist the patient in performing

these simple exercises since the patient is unable to move due to the
pain she is experiencing. These exercises are essential for enhancing
Active and Passive blood circulation and preventing joint stiffness. Simple raising and lifting
Range of Motion of the arms and legs are beneficial. Range of motion exercises, which
(ROM) Exercises involve moving joints are particularly important. These exercises help
maintain flexibility and mobility, and improve overall muscle function.
Regularly practicing range of motion (ROM) exercises can greatly
contribute to the patient's physical well-being
 REVIEW RELATED LITERATURE
International

According to Brown, M. A., et al. (2021), an international study, states that preeclampsia remains a major cause of maternal and perinatal morbidity and mortality
worldwide. Early identification and close monitoring are vital to reducing complications such as eclampsia and HELLP syndrome, which often arise in the third
trimester of pregnancy.

According to Henderson, J. T., et al. (2021), an international study, states that preeclampsia is associated with higher rates of cesarean delivery and preterm
birth. Prompt recognition and medical management can significantly improve maternal and neonatal outcomes.

According to Chappell, L. C., & Magee, L. A. (2022), an international study, states that elevated blood pressure, proteinuria, and signs of end-organ damage are
diagnostic hallmarks of preeclampsia. This condition is now recognized as a systemic disorder rather than a solely placental issue.

According to Webster, K., et al. (2025), an international study, states that despite advancements in prenatal care, preeclampsia continues to disproportionately
affect women in low- and middle-income countries due to lack of access to screening and antihypertensive therapy.

According to Wu, P., et al. (2023), an international study, states that preeclampsia is a strong predictor of fetal growth restriction (FGR), with impaired
uteroplacental blood flow being a leading cause of small-for-gestational-age births.

According to Redman, C. W., & Sargent, I. L. (2022), an international study, states that oxidative stress and immune maladaptation contribute to the pathogenesis
of preeclampsia, reinforcing the theory that it is both an inflammatory and vascular condition.

According to Melchiorre, K., et al. (2024), an international study, states that early-onset preeclampsia before 34 weeks is more strongly associated with adverse
maternal and perinatal outcomes than late-onset preeclampsia, requiring different management approaches.

According to Bartsch, E., et al. (2025), an international study, states that aspirin prophylaxis initiated before 16 weeks of gestation has shown a reduction in the
incidence of preeclampsia among high-risk women, supporting its use as a preventive strategy.
 REVIEW RELATED LITERATURE
Local

According to Reyes, J. A., & Castillo, M. F. (2021), a local study, states that preeclampsia remains one of the leading causes of maternal death in the
Philippines, particularly in rural areas where prenatal care is delayed or inadequate.

According to Dela Cruz, R. M., & Navarro, J. B. (2023), a local study, states that Filipino women with preeclampsia commonly report symptoms such as
headache, blurred vision, and right upper quadrant pain before diagnosis, often leading to late hospital admission.

According to Santos, A. L., et al. (2022), a local study, states that early education and screening for high-risk mothers significantly reduced the incidence of
severe preeclampsia in selected barangay health centers in Central Luzon.

According to Mendoza, C. D., et al. (2024), a local study, states that the most common management of preeclampsia in tertiary hospitals in Metro Manila
includes magnesium sulfate administration, bed rest, and antihypertensives such as labetalol.

According to Fernando, M. A., & Pascual, L. A. (2025), a local study, states that the integration of maternal health education in community-based programs
improved compliance with prenatal visits and early detection of hypertensive disorders in pregnancy.

According to Salazar, N. V., & Dizon, P. R. (2025), a local study, states that health promotion programs led by local government units focusing on maternal
nutrition and hypertension control have shown positive outcomes in reducing cases of preeclampsia in rural barangays.
According to Villanueva, H. P., & Lopez, D. C. (2022), a local study, states that a history of adolescent pregnancy and lack of preconception counseling
increased the risk of hypertensive complications including preeclampsia in women aged 18–25.

According to Abad, K. J., et al. (2024), a local study, states that non-pitting edema, elevated BP, and visual disturbances such as blurring are among the most
consistent clinical signs noted during assessments of preeclamptic patients in public hospitals.
THANK
YOU!