A midwife is assessing a 43 - year - old client at 23 weeks’ gestation. Which of the following findings alerts the midwife of a possible case of pre - eclampsia?
  1. Pre - pregnancy blood pressure: 100/80; Present blood pressure: 130/100
  2. Weight gain of one pound in one week
  3. Proteinuria 0
  4. Edema - absent
Explanation
Answer: A - A possible case of pre - eclampsia is considered if the client’s most recent blood pressure increases to 130/100 mm Hg from a pre - pregnancy blood pressure of 100/80 mm Hg. If the client’s systolic blood pressure increases 30 mm Hg, or if the diastolic pressure increases 15 mm Hg above the pre - pregnancy level, pre - eclampsia is more likely. A weight gain of one pound per week during the second trimester does not indicate a possible pre - eclampsia. Pre - eclampsia is more likely if the client gains more than two pounds during the second trimester. Absence of proteinuria and edema indicate good maternal health.
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