During an eclamptic attack, the priority nursing intervention is:

AIIMS Delhi NO-2016

Obstetrics & Gynaecology

Medium

Appeared in: AIIMS Delhi NO-2016

Explanation

The immediate priority in any seizure, including eclampsia, is to maintain a patent airway, following the ABCs of emergency care (Airway, Breathing, Circulation).
During a tonic-clonic seizure, the patient is at high risk for aspiration of saliva or vomitus and airway obstruction from the tongue falling back.
Securing the airway, often by turning the patient to their side, is the first and most critical action to ensure oxygen can reach the lungs and prevent life-threatening complications for both mother and fetus.

Option A: While Magnesium Sulfate (MgSO₄) is the primary medical treatment to control eclamptic seizures, it is not the first priority. Administering medication comes after securing the airway and ensuring breathing.
Option C: Administering oxygen is crucial (the 'B' in ABCs), but it is ineffective if the airway is blocked. The airway must be cleared first before oxygen can be beneficial.
Option D: Restraining a patient during a seizure is contraindicated as it can lead to severe musculoskeletal injuries, including fractures and dislocations.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Priority nursing interventions during an eclamptic seizure in the correct sequence, documenting the action clearly, and monitoring for the expected response.
In any emergency, the ABC (Airway, Breathing, Circulation) framework provides a structured and reliable approach to prioritize life-saving interventions.
Eclampsia is a life-threatening obstetric emergency. Prompt and correct management is critical to prevent maternal and fetal mortality and morbidity.
What if? If the patient was already receiving an MgSO₄ infusion for pre-eclampsia and then had a seizure, the priority would still be to maintain the airway first. The nurse would then ensure the infusion is running at the correct therapeutic rate or administer a bolus as ordered, but only after addressing the airway.

How to Approach the Question

Identify the core of the question: it asks for the 'priority' intervention. This signals a need to rank actions based on urgency and potential for harm.
Recognize the clinical situation: an 'eclamptic attack' is an active seizure, a life-threatening emergency.
Apply the universal ABC (Airway, Breathing, Circulation) framework to prioritize actions in an emergency.
Evaluate the options against the ABCs: 'Maintain patent airway' directly addresses 'A' (Airway). 'Administer oxygen' addresses 'B' (Breathing). 'Administer MgSO₄' relates to 'C' (Circulation/Treatment). 'Restrain the patient' is a safety measure.
Conclude that Airway is always the first priority over Breathing and Circulation. Therefore, maintaining a patent airway is the correct answer.

Concept Tested & Keywords

Concept Tested: Priority nursing interventions during an eclamptic seizure
Stem keywords: eclamptic attack, priority nursing intervention
Lead-in keywords: priority
Clinical cues: eclamptic attack (indicates an active seizure, a medical emergency)
Negative lead-in flag: false

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 36-44

E6 Obstetrics Williams p. 61-83