All are the cardinal sign of Pre-Eclampsia, except?

Appeared in: HPSSC Staff Nurse - 2021

Explanation

Weight loss is incorrect because the pathophysiology of preeclampsia involves widespread endothelial dysfunction, leading to increased vascular permeability.
This 'leaky' state causes fluid to shift from the intravascular space to the interstitial space, resulting in generalized edema and subsequent weight gain, not weight loss.
Therefore, weight loss is the opposite of what is expected and is the sign that does not belong.

Option A: Proteinuria is a cardinal sign of preeclampsia, reflecting kidney damage from the disease process.
Option B: Increased blood pressure (hypertension) is the hallmark and a primary diagnostic criterion for preeclampsia.
Option C: Edema (swelling) is a classic sign of preeclampsia, caused by pathological fluid retention. It directly contributes to weight gain.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Cardinal Signs of Preeclampsia as background academic context rather than a clinical decision trigger.
Nurses play a vital role in monitoring pregnant women for signs of preeclampsia. This includes accurately measuring blood pressure, checking urine for protein, and assessing for edema and sudden weight gain.
Patient education is critical. The nurse must teach the patient to report warning signs such as severe headaches, visual disturbances (blurriness, spots), severe pain in the upper abdomen, and sudden swelling of the face or hands.
What if? If a patient with mild preeclampsia suddenly reports a severe, persistent headache and her blood pressure is 162/114 mmHg, this indicates a progression to preeclampsia with severe features, which is a medical emergency requiring immediate intervention, including potential administration of magnesium sulfate and preparation for delivery.

How to Approach the Question

First, identify the core concept of the question, which is the 'cardinal signs of Pre-Eclampsia'.
Note the keyword 'except'. This means you are looking for the option that is NOT a sign of preeclampsia.
Recall the classic triad of preeclampsia: hypertension, proteinuria, and edema.
Evaluate each option: 'Proteinuria' is a sign. 'Increased blood pressure' is a sign. 'Edema' is a sign.
Consider the pathophysiology of edema in preeclampsia: it's caused by fluid retention, which leads to weight gain.
Therefore, 'Weight loss' is inconsistent with the disease process and is the correct answer.

Concept Tested & Keywords

Q1Cu2-VFpg1yuLBmzMLqAU

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

E6 Obstetrics Williams p. 69-95

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