Which of the following is NOT a sign of impending eclampsia?

Appeared in: ISRO 2024

Explanation

A raised body temperature (fever) is not a premonitory or warning sign of an impending eclamptic seizure.
Fever is more commonly observed after a convulsion has already occurred (postictal phase).
This post-seizure temperature elevation is attributed to the intense muscular exertion during the fit, which also raises the pulse and respiratory rates.

Option A: Persistent frontal or occipital headache is a classic and ominous symptom of impending eclampsia.
Option B: Diminished urine output, or oliguria (less than 400-500 mL/24h), is a key indicator of severe preeclampsia and impending eclampsia.
Option D: Epigastric pain, often described as right upper quadrant pain, is a critical warning sign of impending eclampsia.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Signs and symptoms of impending eclampsia as background academic context rather than a clinical decision trigger.
A nurse's ability to promptly recognize the warning signs of impending eclampsia is a critical patient safety competency. These signs indicate that preeclampsia is progressing to its most severe form.
Identification of these symptoms should trigger immediate notification of the healthcare provider and preparation for interventions like administering magnesium sulfate to prevent seizures, which can be life-threatening for both mother and fetus.
Nursing assessment must include specific questions about headaches, visual changes, and epigastric pain in all patients with hypertension in pregnancy.

How to Approach the Question

First, identify that the question uses the negative keyword 'NOT'. This means you are looking for the option that is an exception or does not fit with the others.
Recall the signs and symptoms of severe preeclampsia, which are also the warning signs of impending eclampsia.
Evaluate each option: Is 'Persistent frontal headache' a sign? Yes, it's a key neurological sign.
Is 'Diminished urine output' a sign? Yes, oliguria indicates severe renal dysfunction.
Is 'Raised body temperature' a sign? Think about the pathophysiology. Fever is a sign of infection or inflammation, not typically a direct result of the vasospasm and endothelial damage of preeclampsia itself before a seizure.
Is 'Epigastric pain' a sign? Yes, it indicates liver involvement.

Concept Tested & Keywords

Concept Tested: Signs and symptoms of impending eclampsia
Stem keywords: impending eclampsia, sign
Lead-in keywords: NOT
Negative lead-in flag: The question asks for the option that is NOT a sign of impending eclampsia.

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E6 Obstetrics Williams p. 2-9

Practise the full ISRO 2024

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