Which finding indicates worsening preeclampsia in a patient under home care and requires notifying the primary health care provider?

• A. Urinary output has increased.
• B. Dependent edema has resolved.
• C. Blood pressure reading is at the prenatal baseline.
• D. The client complains of a headache and blurred vision.

Answer: (D)

Neurologic symptoms such as a severe headache and visual disturbances signal progression to severe preeclampsia with CNS involvement. This is a red flag that requires urgent assessment by the primary health care provider because it raises the risk of seizures (eclampsia) and indicates the condition may be worsening even if other signs seem stable at home. Prompt evaluation helps determine if hospitalization, continued monitoring, or treatment adjustments (like antihypertensives or magnesium sulfate) are needed.

By comparison, increased urine output suggests renal function is adequate or improving, edema that has resolved points to improvement, and a blood pressure reading at the baseline indicates stability. None of these imply the same level of danger as new headaches with vision changes. If these symptoms occur, the patient should contact the provider or seek immediate care.