Question

A 29-week-gestation woman diagnosed with severe preeclampsia is noted to have blood pressure of 170/112, 4+ proteinuria, and a weight gain of 10 pounds over the last 2 days. Which of the following signs/symptoms would the nurse also expect to see?

1) Fundal height of 32 cm.
2) Papilledema.
3) Patellar reflexes of +2.
4) Nystagmus.

Answer 1

In severe preeclampsia, papilledema is the most likely additional symptom due to increased intracranial pressure. Other options, such as fundal height of 32 cm and patellar reflexes of +2, are unremarkable or normal, and nystagmus is not typically associated with preeclampsia.

Step-by-step explanation:

The student's question pertains to the expected findings in a woman with severe preeclampsia at 29 weeks of gestation. Amongst the provided options, the most likely symptom a nurse would expect to see with severe preeclampsia is papilledema, which is option 2. Papilledema refers to the swelling of the optic disc and is a sign of increased intracranial pressure, a possible complication of severe preeclampsia. This can be explained by the pathophysiology of preeclampsia, which includes systemic vasoconstriction and endothelial dysfunction leading to increased blood pressure and potential end-organ damage. With respect to option 1, the fundal height tends to correspond with the number of weeks of gestation, so a 32 cm fundal height would be unremarkable at 29 weeks. Option 3, patellar reflexes of +2, is also considered a normal finding. Lastly, option 4, nystagmus, is an involuntary eye movement that is not typically associated with preeclampsia.