A client at 32 weeks gestation is diagnosed with preeclampsia. Which assessment finding is most indicative of an impending convulsion?

The assessment finding that is most indicative of an impending convulsion in a client diagnosed with preeclampsia is the presence of 3+ deep tendon reflexes and hyperclonus. This suggests that the neuromuscular excitability is heightened, which is a key characteristic of worsening preeclampsia and can precede convulsions. Hyperactive deep tendon reflexes indicate an overstimulation of the nervous system, which is a direct response to the cerebral irritability associated with severe forms of preeclampsia.

In preeclampsia, the risk of progression to eclampsia, characterized by seizures, increases as the condition worsens. The presence of hyperclonus specifically indicates a state where the body is more susceptible to seizures, making these findings critical in monitoring a patient’s status.

Other findings such as periorbital edema, flashing lights, and aura may suggest severe preeclampsia or impending eclamptic seizure, but they are not as directly indicative of imminent convulsions as hyperreflexia and hyperclonus. Similarly, epigastric pain is an important symptom that requires attention as it may indicate liver involvement, but it does not directly relate to the neuromuscular