Aclient at 24 weeks gestation comes to the clinic for a prenatal check-up and informs the nurse that she has been "seeing double." the nurse checks the urine and determines that there is 3+ proteinuria. what does the nurse determine is the potential priority problem?

Double vision is one of the danger signs associated with pregnancy. Once this is present, work-up for pre-eclampsia should be done. Urinalysis showed 3+ proteinuria which confirms the diagnosis of pre-eclampsia. The potential priority problem in this case is the deranged blood pressure of the patient who is either previously normal or diagnosed with chronic hypertension. The attending physician should give antihypertensives that are safe for pregnancy (hydralazine, nifedipine, methyldopa, etc.). Pre-eclampsia can manifest as early as after 20 weeks age of gestation.

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