RN Nursing · High-Risk Pregnancy — Hypertensive Disorders · Practice question
A nurse is assessing a client who is pregnant and has preeclampsia. Which of the following findings should the nurse expect?
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Platelet count 200,000/mm3
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✓
Report of blurred vision
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Report of urinary urgency
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Hemoglobin 10 g/dL
Answer & explanation
Correct: Report of blurred vision
Preeclampsia is a hypertensive disorder of pregnancy characterized by hypertension (blood pressure ≥140/90 mmHg) after 20 weeks of gestation along with signs of end-organ damage. Blurred vision is a classic neurological manifestation of preeclampsia, resulting from cerebral vasospasm, retinal arterial spasm, and increased intracranial pressure. It signals significant cerebrovascular involvement and warrants immediate attention. A platelet count of 200,000/mm³ is within the normal range; in preeclampsia, platelet counts are typically decreased (below 100,000/mm³) due to platelet aggregation and consumption, especially in the severe variant HELLP syndrome. Urinary urgency is not a hallmark of preeclampsia; rather, the nurse would expect oliguria (less than 500 mL/24 hours) caused by reduced renal perfusion and glomerular damage. A hemoglobin of 10 g/dL indicates anemia, which is not a defining feature of preeclampsia; instead, hemoconcentration can occur, and in HELLP syndrome hemolysis leads to a low hemoglobin, but simple anemia alone is not characteristic. Therefore, reporting blurred vision is the expected finding consistent with preeclampsia-related end-organ involvement.
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