What should be the first step in managing a patient with severe hypertension during pregnancy?

When managing a patient with severe hypertension during pregnancy, the first step should be the administration of antihypertensive medications. This is crucial because severe hypertension poses significant risks to both the mother and the fetus, including the potential for strokes, placental abruption, and fetal growth restrictions.

The prompt reduction of blood pressure is essential to mitigate these risks. Antihypertensive medications help to lower blood pressure to safe levels quickly and efficiently. It's important to use medications that are established as safe for use during pregnancy to protect the health of both the mother and unborn child.

While regular monitoring of vital signs is important in managing hypertension, doing so does not directly address the immediate need to lower elevated blood pressure. Similarly, bed rest might provide some comfort but does not actively treat the hypertension. Consultation with a nutritionist can be beneficial in the long term for dietary management but is not an immediate intervention necessary during a hypertensive crisis.

Therefore, initiating treatment with antihypertensive medications as the first step ensures that the priority of safeguarding both maternal and fetal health is met promptly.