What is the range of blood pressure during pregnancy with preeclampsia patient?

NORCET 3 - 2022 (Shift-1)

Obstetrics & Gynaecology

Easy

Appeared in: NORCET 3 - 2022 (Shift-1)

Explanation

Preeclampsia is a hypertensive disorder of pregnancy diagnosed by new-onset high blood pressure after 20 weeks of gestation.
The primary diagnostic criterion is a blood pressure reading that is persistently equal to or greater than 140 mm Hg systolic or 90 mm Hg diastolic.
These elevated readings must be documented on at least two separate occasions, a minimum of four hours apart.
The diagnosis can also be made with a single severely elevated reading (≥160/110 mm Hg) or if hypertension is accompanied by other signs of end-organ dysfunction, such as proteinuria, low platelet count, impaired liver function, or new-onset headaches or visual disturbances.

Option B: A blood pressure of 130/90 mm Hg is considered elevated, but the systolic value is below the 140 mm Hg threshold required for a diagnosis of preeclampsia. While the diastolic pressure meets the criterion, both systolic and diastolic thresholds are considered.
Option C: A reading of 164/84 mm Hg has a systolic pressure that meets the criteria for severe preeclampsia (≥160 mm Hg). However, the diastolic pressure is below the 90 mm Hg threshold. While this is a clinically significant hypertensive reading, the option 'More than 140/90 mm of hg' provides the general diagnostic criterion for preeclampsia, not just one specific severe example.
Option D: A blood pressure of 120/80 mm Hg is considered normal and is the target blood pressure for a healthy individual, including during pregnancy.

Visual 1: Chart - A chart illustrating the different classifications of blood pressure in pregnancy (Normal, Gestational Hypertension, Preeclampsia, Severe Preeclampsia) with their corresponding systolic and diastolic values. This helps to visually differentiate the diagnostic thresholds.
Visual 2: Infographic - An infographic showing the signs and symptoms of preeclampsia, including high blood pressure, proteinuria, severe headaches, vision changes, and upper abdominal pain. This reinforces the multi-system nature of the condition.

Clinical Relevance

Nursing practice connection: Use the key finding related to Diagnostic criteria for preeclampsia to guide bedside assessment, documentation, and the next nursing action.
Accurate blood pressure measurement is a critical nursing skill in antenatal care. Incorrect cuff size or patient positioning can lead to inaccurate readings, potentially delaying the diagnosis of preeclampsia.
Nurses must educate patients about the warning signs of worsening preeclampsia, such as severe headaches, visual disturbances (blurriness, flashing lights), and right upper quadrant pain, and instruct them to report these symptoms immediately.
Management of severe preeclampsia involves administering magnesium sulfate for seizure prophylaxis. The nurse's role includes monitoring for signs of magnesium toxicity, such as loss of deep tendon reflexes, respiratory depression, and decreased urine output.

How to Approach the Question

First, identify the core concept of the question, which is the diagnostic criteria for preeclampsia.
Recall the specific blood pressure values that define hypertension in pregnancy. The key threshold is 140/90 mm Hg.
Evaluate each option against this standard criterion.
Option A ('More than 140/90 mm of hg') directly reflects the diagnostic threshold.
Option B ('130/90 mm of Hg') is incorrect because the systolic pressure is too low.
Option C ('164/84 mm of Hg') is an example of severe systolic hypertension but doesn't represent the general diagnostic rule, and the diastolic is normal.

Concept Tested & Keywords

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