Which complication is the most concerning for a nurse to monitor in a pregnant client with a history of high blood pressure?

Monitoring for preeclampsia is particularly crucial in a pregnant client with a history of high blood pressure because this condition is characterized by the onset of hypertension and often proteinuria after 20 weeks of gestation. Women with pre-existing hypertension are at a significantly increased risk for developing preeclampsia, which can lead to serious complications for both the mother and the fetus, including organ dysfunction, placental insufficiency, and increased risk for maternal and fetal morbidity and mortality.

Recognizing the signs and symptoms of preeclampsia early—such as elevated blood pressure, swelling, and headaches—allows healthcare providers to intervene promptly. In contrast, while placental abruption, gestational diabetes, and preterm labor are also important considerations in pregnancy, they do not pose the same immediate and severe risks associated with the vascular complications and systemic effects of preeclampsia, especially in a client with a history of high blood pressure. Thus, prioritizing monitoring for preeclampsia is essential for ensuring the safety and health of both the mother and the developing baby.