Severe preeclampsia can progress to eclampsia, where a seizure occurs. The highest priority in the plan of care is to prevent injury and be ready to intervene quickly if a seizure begins. Initiating seizure precautions establishes that readiness: having suction and oxygen readily available, ensuring a patent airway, and keeping the patient in a safe environment where staff can monitor closely. It also supports readiness for magnesium sulfate therapy, which is commonly used to prevent seizures in this condition. While reducing environmental stimulation or isolating the patient in a dimmer room might help minimize triggers, they don’t address the immediate need to safeguard the patient and respond to a seizure.

Blurred vision signals end‑organ involvement from preeclampsia. When gestational hypertension progresses, signs like visual disturbances indicate cerebral or retinal involvement due to severe vasospasm and endothelial dysfunction, signaling a need for urgent evaluation and potential escalation of care. Swelling that has decreased would mean improvement, not worsening. A heartburn episode after spicy food is common and not a reliable indicator of disease progression. A recent headache that responded to acetaminophen could be benign or mild; in preeclampsia, a persistent or severe headache, especially if not relieved, would raise concern, but the clear red SAMPLEflag here is the visual change. If vision becomes fuzzy, seek immediate medical attention for maternal and fetal assessment.

Colostrum discharge from both breasts is the best sign that breastfeeding is starting in the early postpartum period. Colostrum is the first, sticky, yellowish milk produced in small amounts during the first few days after birth. It’s rich in antibodies and nutrients, helping protect and nourish the newborn while the milk supply adjusts. Seeing colostrum indicates lactation is beginning and the baby can begin early feeding. Other findings aren’t as reliable as indicators of normal early breastfeeding: mild afterpains can occur as the uterus contracts, but they aren’t a direct sign of lactation; lochia that is bright red and foul-smelling suggests infection or another problem; and headaches or dizziness can happen postpartum but don’t specifically reflect normal breastfeeding onset.

Iron-deficiency anemia in pregnancy is best addressed by restoring iron stores through supplementation, while also using dietary iron and strategies that enhance absorption and minimize side effects. Oral iron helps replenish iron stores and raise hemoglobin, and including iron-rich foods supports ongoing intake. Taking iron with vitamin C improves absorption of non-heme iron from foods and supplements. Because iron can irritate the gut, it’s important to counsel about potential constipation and the normal change of stools to a darker color; practical tips include drinking fluids, staying active if possible, and taking iron with meals if needed to reduce GI upset, while noting that darker stools are a common and harmless effect. Iron-free diets do not treat the deficiency, and vitamin B12 injections or folic acid alone do not correct iron-deficiency anemia, though folic acid remains important for fetal development. If a patient does not tolerate oral iron or has a severe deficiency, other options like intravenous iron may be considered under supervision.