A home-care nurse is monitoring a gestational hypertension patient; which finding would indicate progression requiring evaluation?

• A. Blood pressure stable
• B. Weight decreasing
• C. Fetal movement slowing
• D. Proteinuria increasing

Answer: (D)

Rising protein in urine signals progression from gestational hypertension to preeclampsia. Gestational hypertension involves elevated blood pressure after 20 weeks without proteinuria or other systemic signs. When proteinuria increases, it indicates renal involvement and endothelial dysfunction, hallmark features of preeclampsia, which carries higher maternal and fetal risk and requires closer evaluation and possible intervention.

The other findings don’t point to this progression as clearly: stable blood pressure suggests the condition hasn’t advanced; weight loss isn’t a typical or reliable sign of progression in pregnancy; and slowing fetal movement can raise concern for fetal well-being but doesn’t specifically indicate worsening maternal disease to preeclampsia.