At 28 weeks gestation, which change should be reported to the Certified Nurse Midwife?

The change in blood pressure from 110/70 to 140/90 at 28 weeks gestation is significant and should be reported to the Certified Nurse Midwife. A blood pressure reading in this range indicates the potential onset of hypertension, which can lead to serious conditions such as preeclampsia. Monitoring blood pressure is crucial during pregnancy, as elevated readings can have implications for both maternal and fetal health.

In contrast, the other changes noted are less concerning. A weight increase of 4 pounds is generally considered normal during this stage of pregnancy, reflecting typical weight gain. A pulse increase from 88 to 92 beats per minute is within a normal physiological range for a pregnant person. Similarly, a respiratory rate change from 16 to 20 breaths per minute may not indicate a significant issue, as slight variations in respiratory rate can occur during pregnancy due to increased oxygen demand for both the mother and fetus. Therefore, the change in blood pressure is the priority concern that necessitates further evaluation and monitoring.