Which of the following sign is not associated with preeclampsia?

RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Obstetrics & Gynaecology

Medium

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Explanation

Seizures are the hallmark sign of eclampsia, which is a severe complication of preeclampsia, not a sign of preeclampsia itself.
Eclampsia is diagnosed when a patient with preeclampsia experiences generalized tonic-clonic convulsions that cannot be attributed to other causes.
Preeclampsia is the hypertensive disorder that precedes the onset of seizure activity.
The management and urgency differ significantly; preeclampsia management focuses on preventing seizures, while eclampsia management focuses on stopping active seizures and immediate delivery.

Option A: Hypertension is a cardinal sign and a primary diagnostic criterion for preeclampsia. It is defined as a blood pressure of 140/90 mmHg or higher on two occasions at least 4 hours apart after 20 weeks of gestation in a previously normotensive woman.
Option C: Generalized edema, particularly of the hands, face, and lower extremities, is a very common and classic clinical sign in preeclampsia. It results from endothelial dysfunction, leading to increased capillary permeability and fluid shifting into the interstitial space.
Option D: Proteinuria is a hallmark sign of preeclampsia and a key diagnostic criterion. It reflects kidney damage (glomerular endotheliosis) caused by the disease process, leading to protein spilling into the urine.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Differential diagnosis between preeclampsia and eclampsia as background academic context rather than a clinical decision trigger.
Nurses must vigilantly monitor patients with preeclampsia for warning signs of progression to eclampsia, such as severe headaches, visual disturbances (blurriness, spots), epigastric pain, and hyperreflexia.
The primary goal of nursing care for a patient with preeclampsia is to ensure maternal and fetal safety, prevent seizures, and control hypertension.
What if? If a patient with preeclampsia suddenly reports a severe, blinding headache and becomes disoriented, the nurse's priority is to anticipate an imminent seizure. The nurse should ensure the patient is in a safe position (e.g., side-lying), call for immediate help, have seizure precautions (padded side rails, suction) ready, and prepare to administer magnesium sulfate as per emergency protocol. The condition is escalating to severe preeclampsia or eclampsia.

How to Approach the Question

First, identify the negative framing of the question, which uses the word "not". This means you are looking for the option that does not fit with the diagnosis.
Next, recall the core definition and clinical presentation of preeclampsia. The classic triad is Hypertension, Proteinuria, and Edema.
Evaluate each option against this core knowledge.
Option A (Hypertension), Option C (Generalized edema), and Option D (Proteinuria) are all well-known signs associated with preeclampsia.
Consider Option B (Seizures). Recall that seizures are the defining characteristic that elevates the diagnosis from preeclampsia to the more severe condition, eclampsia.
Therefore, seizures are the sign that is not associated with preeclampsia itself but rather with its progression to eclampsia, making it the correct answer.

Concept Tested & Keywords

Concept Tested: Differential diagnosis between preeclampsia and eclampsia.
Stem keywords: preeclampsia, sign
Lead-in keywords: not associated
Negative lead-in flag: Question asks for the sign NOT associated with preeclampsia.

Qfc7WW2d_ZuU-xhurFN9FT

E6 Obstetrics Williams p. 2-9

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