A pregnant woman complains of headache, abdominal pain, vomiting and blackouts. This suggests which of the co… - NHM MP Staff Nurse-2019

NHM MP Staff Nurse-2019

Obstetrics & Gynaecology

Easy

Appeared in: NHM MP Staff Nurse-2019

Explanation

The patient's symptoms—headache, abdominal pain, vomiting, and blackouts (visual disturbances)—are a classic constellation of warning signs for severe pre-eclampsia.
These symptoms indicate multi-organ involvement, specifically affecting the central nervous system (headache, visual changes) and the liver (epigastric pain, vomiting).
This clinical picture reflects the underlying pathophysiology of pre-eclampsia, which includes widespread vascular endothelial damage, vasospasm, and ischemia.
The presence of these 'ominous' or 'severe feature' symptoms signifies a high risk of progression to eclampsia (seizures) and other serious maternal and fetal complications.

Option A: Anaemia typically presents with symptoms like fatigue, pallor, shortness of breath, and dizziness. It does not characteristically cause the acute and severe combination of neurological and upper abdominal symptoms seen in the question.
Option C: Gestational Diabetes Mellitus (GDM) is a condition of high blood sugar during pregnancy. Its classic symptoms are polyuria (frequent urination), polydipsia (increased thirst), and polyphagia (increased hunger). The acute, severe symptoms in the question are not associated with GDM.
Option D: This option is incorrect because the symptoms described are a textbook presentation of a specific, well-known pregnancy complication.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Recognition of signs and symptoms of severe pre-eclampsia as background academic context rather than a clinical decision trigger.
Recognizing these symptoms as severe pre-eclampsia is a critical nursing responsibility. It is a medical emergency that requires immediate intervention.
Immediate nursing actions include checking the patient's blood pressure, assessing for proteinuria, implementing seizure precautions (quiet, dim room), and preparing for the administration of magnesium sulfate to prevent eclampsia.
Failure to act quickly can lead to eclampsia, HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets), placental abruption, and maternal or fetal death.

How to Approach the Question

First, analyze the patient's profile: a pregnant woman.
Next, identify the key symptoms presented: headache, abdominal pain, vomiting, and blackouts.
Recognize that these symptoms affect multiple body systems: neurological (headache, blackouts) and gastrointestinal/hepatic (abdominal pain, vomiting).
Consider the options provided. Evaluate which condition is known to cause this specific pattern of multi-system dysfunction in pregnancy.
Recall or deduce that severe pre-eclampsia is a systemic disease characterized by vasospasm and endothelial damage, leading to precisely these symptoms.
Eliminate other options. Anaemia and Gestational Diabetes have different, non-overlapping primary symptoms.

Concept Tested & Keywords

Concept Tested: Recognition of signs and symptoms of severe pre-eclampsia.
Stem keywords: pregnant woman, headache, abdominal pain, vomiting, blackouts
Lead-in keywords: suggests which
Clinical cues: The combination of neurological (headache, blackouts) and hepatic (abdominal pain) symptoms in a pregnant patient is a red flag for a systemic process.

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E6 Obstetrics Williams p. 2-9

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 34-42