What should be the next step if a patient with known hypertension presents with a significantly elevated BP reading of 156/98 mm Hg?

When a patient with known hypertension presents with a significantly elevated blood pressure reading, it is crucial to assess for possible superimposed preeclampsia. Preeclampsia is a serious condition that can develop in women with chronic hypertension during pregnancy and is characterized by the new development of hypertension and proteinuria after 20 weeks of gestation.

An elevated blood pressure reading, particularly one that exceeds the normal range, may indicate that the patient is experiencing deterioration in her hypertensive state or could potentially be progressing toward preeclampsia. By conducting an assessment for superimposed preeclampsia, healthcare providers can evaluate for additional signs such as the presence of protein in the urine, elevated liver enzymes, or symptoms of end-organ dysfunction. This assessment is vital to ensure that appropriate interventions are made to protect both the mother and fetus from potential complications associated with the condition.

While other options such as initiating a medication regimen or scheduling a follow-up appointment might seem relevant, they do not address the immediate need to rule out the more severe condition of preeclampsia, which requires urgent evaluation and management. Discharging the patient without further evaluation would also be inappropriate considering the elevated blood pressure reading, as it does not ensure that the