Pregnant Women admitted in labor with complaint of hypertension 161/101, proteinuria grade +3, and seizure. A prudent nurse knows that this condition is?

Appeared in: PGIMER NO - 2020

Explanation

Eclampsia is the correct diagnosis as it is defined by the onset of seizures (convulsions) in a woman with preeclampsia.
The patient presents with the classic triad of symptoms for eclampsia: severe hypertension (161/101 mmHg), significant proteinuria (+3), and a seizure.
The presence of a seizure is the key feature that differentiates eclampsia from preeclampsia, representing a severe progression of the disease.

Option A: This is incorrect because gestational hypertension is defined as high blood pressure developing after 20 weeks of gestation without the presence of proteinuria. This patient has significant proteinuria (+3).
Option B: While the patient does have the underlying condition of preeclampsia (hypertension and proteinuria), the diagnosis is elevated to eclampsia because of the seizure. Eclampsia is the most severe form of preeclampsia.
Option D: This is a general classification for blood pressure and not a specific diagnosis for this complex, pregnancy-related syndrome. It fails to account for the critical findings of proteinuria and seizures, which define the condition.

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Diagnosis of hypertensive disorders in pregnancy in acute care settings.
Eclampsia is a life-threatening obstetric emergency requiring immediate intervention to prevent maternal and fetal morbidity and mortality.
The priority nursing actions are to manage the seizure, maintain a patent airway, ensure patient safety, and administer magnesium sulfate as ordered to prevent further seizures.
The definitive treatment for eclampsia is delivery of the fetus and placenta, which should be accomplished as soon as the mother is stabilized.

How to Approach the Question

First, analyze the clinical data provided in the stem. Identify the key findings for the pregnant patient.
List the findings: 1. Hypertension (161/101 mmHg), 2. Proteinuria (+3), and 3. Seizure.
Next, evaluate the options based on their precise medical definitions in the context of pregnancy.
Recall the definitions: Gestational hypertension involves high BP but no proteinuria. Preeclampsia involves high BP and proteinuria. Eclampsia includes all signs of preeclampsia plus the onset of seizures.
Match the patient's triad of symptoms to the correct diagnosis. The presence of a seizure is the definitive sign that elevates the condition from preeclampsia to eclampsia.

Concept Tested & Keywords

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

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

E6 Obstetrics Williams p. 2-9

Practise the full PGIMER NO - 2020

Attempt every question from this paper in a timed mock, then review the full solution for each one.