Editing Maternal and Newborn Nursing – RN Practice Questions (section)

==Question 3==
A nurse is evaluating a client at 34 weeks' gestation with gestational hypertension. Which findings indicate progression to preeclampsia '''with severe features'''? '''Select all that apply.'''
# Blood pressure 164/112 mm Hg on two readings 6 hours apart
# Platelet count 68,000/mm3
# Trace proteinuria on dipstick
# New-onset headache unrelieved by acetaminophen with blurred vision
# Serum aspartate aminotransferase (AST) three times the upper limit of normal
# Dependent ankle edema after standing all day

'''Answer:''' 1, 2, 4, 5 (A, B, D, E).

''Rationale:'' Severe features include systolic pressure of 160 mm Hg or higher or diastolic of 110 mm Hg or higher on two occasions, thrombocytopenia below 100,000/mm3, new cerebral or visual disturbance, impaired liver function or severe persistent right upper quadrant pain, renal insufficiency, and pulmonary edema. Option 3 is wrong because the ''degree'' of proteinuria is not used to define severe disease; a client can have severe preeclampsia with little or no protein. Option 6 is wrong because dependent lower extremity edema is a common normal finding in late pregnancy; sudden facial and hand edema is the concerning pattern, and even that is not a diagnostic criterion.