A nurse is preparing to discharge a client with gestational hypertension who delivered a healthy baby two days ago.

Which of the following instructions should the nurse include in the discharge teaching?

The correct answer is choice B. The client has severe preeclampsia and needs immediate delivery.Severe preeclampsia is diagnosed when the blood pressure is at least 160/100 mmHg, the urine protein is 3+ or more, and there are signs of organ damage or central nervous system involvement, such as brisk deep tendon reflexes and clonus.These findings indicate a high risk of eclampsia, which is a life-threatening condition characterized by seizures.Immediate delivery is the only definitive treatment for preeclampsia and eclampsia.

Choice A is wrong because the client has more than mild preeclampsia.Mild preeclampsia is diagnosed when the blood pressure is at least 140/90 mmHg, the urine protein is 1+ or 2+, and there are no signs of organ damage or central nervous system involvement.Close monitoring may be appropriate for mild preeclampsia, depending on the gestational age and fetal status.

Choice C is wrong because the client does not have eclampsia yet.Eclampsia is diagnosed when the client has preeclampsia and seizures.Magnesium sulfate and anticonvulsants are used to prevent and treat seizures in eclampsia, but they do not cure preeclampsia.Delivery is still necessary to resolve the condition.

Choice D is wrong because the client does not have chronic hypertension.Chronic hypertension is high blood pressure that was present before pregnancy or that occurs before 20 weeks of gestation.The client’s blood pressure was normal before pregnancy and increased after 20 weeks of gestation, indicating gestational hypertension or preeclampsia.

Antihypertensive medication adjustment may be needed for chronic hypertension

The correct answer is choice B. You should continue taking your antihypertensive medication as prescribed.This is because gestational hypertension can persist for several days or weeks after delivery and may increase your risk of complications such as stroke or heart failure.You should also monitor your blood pressure at home and report any abnormal readings to your provider.

Choice A is wrong because you should not avoid breastfeeding your baby unless your provider advises you to do so.Breastfeeding has many benefits for both you and your baby and does not affect your blood pressure.

Choice C is wrong because you do not need to limit your sodium intake to less than 2 grams per day unless your provider tells you to do so.There is no evidence that sodium restriction lowers blood pressure or prevents preeclampsia in pregnant women.

Choice D is wrong because you should have a follow-up appointment with your provider within one week after delivery, not six weeks.This is to check your blood pressure, review your medication, and screen for any postpartum complications.