A multi system disorder of unknown etiology characterized by hypertension (140/90 mm of hg or above) with proteinuria after 20th week of pregnancy is called?

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2018

Explanation

The question describes the classic diagnostic triad for pre-eclampsia: new-onset hypertension (≥140/90 mmHg), proteinuria, and an onset after 20 weeks of gestation.
Pre-eclampsia is a multisystem disorder specific to pregnancy, caused by placental dysfunction, which leads to widespread maternal endothelial damage.
The presence of proteinuria is a key feature that distinguishes pre-eclampsia from gestational hypertension.

Option A: Gestational hypertension is characterized by new-onset hypertension after 20 weeks of gestation but, by definition, occurs in the absence of significant proteinuria.
Option C: Eclampsia is the most severe form of pre-eclampsia, defined by the presence of new-onset generalized tonic-clonic seizures in a patient with pre-eclampsia. The question does not mention seizures.
Option D: Chronic hypertension is high blood pressure that is present before pregnancy or diagnosed before the 20th week of gestation. The question specifies the onset is after the 20th week.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Diagnosis of Hypertensive Disorders in Pregnancy as background academic context rather than a clinical decision trigger.
Early identification and management of pre-eclampsia are critical to prevent progression to severe disease, eclampsia, and other life-threatening complications for both mother and fetus, such as HELLP syndrome and placental abruption.
Nurses must educate patients on the importance of attending all prenatal appointments for regular blood pressure and urine checks, as pre-eclampsia can develop rapidly and sometimes without obvious symptoms.
What if? If the patient presented with a blood pressure of 170/115 mmHg and a severe headache, the condition would be classified as pre-eclampsia with severe features, requiring immediate stabilization, administration of magnesium sulfate for seizure prophylaxis, and consideration for urgent delivery, regardless of gestational age.

How to Approach the Question

First, identify the key clinical criteria presented in the question stem: 1) hypertension (≥140/90 mmHg), 2) proteinuria, and 3) onset after the 20th week of pregnancy.
Next, analyze the options provided, which are all hypertensive disorders of pregnancy.
Recall the specific definition for each disorder. Compare the criteria from the question to the definitions.
Gestational hypertension has no proteinuria. Eclampsia has seizures. Chronic hypertension begins before 20 weeks.
Conclude that the combination of hypertension, proteinuria, and onset after 20 weeks perfectly matches the definition of pre-eclampsia.

Concept Tested & Keywords

Concept Tested: Diagnosis of Hypertensive Disorders in Pregnancy
Stem keywords: multi system disorder, hypertension, 140/90 mm of hg, proteinuria, after 20th week, pregnancy
Lead-in keywords: is called

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E6 Medicine Harrison 22e Part 2 p. 1803-1805

E6 Obstetrics Williams p. 2-9

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