Which of the following signs and symptoms may indicate worsening condition or preeclampsia in a client with gestational hypertension?

The correct answer is choice A, B, C and E.These are all risk factors for gestational hypertension according to various sources.

Some possible explanations for each choice are:

• Choice A: Maternal age over 35 years.Older women are more likely to have chronic hypertension, diabetes, or other conditions that increase the risk of gestational hypertension.

• Choice B: First pregnancy.Women who are pregnant for the first time are more likely to develop gestational hypertension than women who have had previous pregnancies.

• Choice C: Multiple gestation.Women who are carrying twins, triplets, or more are more likely to have gestational hypertension because of the increased placental mass and blood volume.

• Choice D: History of diabetes mellitus.This is not a risk factor for gestational hypertension, but it is a risk factor for preeclampsia, which is a more severe form of hypertension that involves proteinuria and organ damage.

Preeclampsia can develop from gestational hypertension or occur independently.

• Choice E: African American race.African American women are more likely to have gestational hypertension than women of other races or ethnicities.

This may be due to genetic, environmental, or social factors that affect blood pressure regulation.

Normal ranges for blood pressure during pregnancy are less than 140/90 mmHg.Gestational hypertension is diagnosed when blood pressure is greater than or equal to 140/90 mmHg after 20 weeks of pregnancy and there is no proteinuria or other signs of preeclampsia.Gestational hypertension usually goes away after delivery, but it can increase the risk of complications for both the mother and the baby.

The correct answer is choice D) Level of consciousness and reflexes.This is because magnesium sulfate can cause toxicity and affect the central nervous system, leading to decreased level of consciousness and loss of reflexes.These are signs that the dose of magnesium sulfate should be reduced or stopped.

The nurse should prioritize assessing these parameters to prevent seizures and avoid magnesium toxicity.

Choice A) Respiratory rate and depth is wrong because magnesium sulfate can also cause respiratory depression, but this is a less common and less sensitive indicator of toxicity than level of consciousness and reflexes.

Choice B) Urine output and color is wrong because magnesium sulfate can also cause renal impairment, but this is not directly related to preventing seizures.However, urine output should be monitored to ensure adequate hydration and renal function.

Choice C) Blood pressure and heart rate is wrong because magnesium sulfate can also cause hypotension and bradycardia, but these are not the primary goals of therapy.Blood pressure and heart rate should be monitored to assess the severity of preeclampsia and the response to antihypertensive medications.