A multigravida client at 35-weeks gestation is diagnosed with pregnancy-induced hypertension (PIH). Which symptom should the nurse instruct the client to report immediately?

• A. Backache.
• B. Constipation.
• C. Blurred vision.
• D. Increased urine output.

Answer: (C)

Blurred vision signals cerebral involvement from pregnancy‑induced hypertension, indicating progression toward severe preeclampsia or impending eclampsia. When vision changes occur in late pregnancy, it reflects significant vascular and neurologic stress that can lead to seizures, stroke, or other serious maternal complications if not addressed immediately. This is why reporting it right away prompts urgent evaluation—blood pressure checks, urine protein assessment, labs, and possible hospitalization with seizure-prevention measures like magnesium sulfate if severe features are present.

Backache can be a common discomfort of pregnancy and isn’t a specific warning for PIH. Constipation isn’t linked to PIH progression, and increased urine output is not a typical red-flag symptom of PIH (renal involvement more commonly corresponds with reduced urine output).