A child with acute glomerulonephritis has a severe headache and very high blood pressure. What is the priority?
- AGive the prescribed oral analgesic and reassess in an hour
- BCheck neurologic status and arrange urgent medical review
- CRestrict sodium and fluids and start daily weights
- DGive a stock antihypertensive now to lower the pressure rapidly
Show answer and explanations
Answer
B
A
Treating the headache as a simple symptom masks a possible hypertensive encephalopathy and delays escalation.
B
Severe headache with very high blood pressure in glomerulonephritis can signal hypertensive encephalopathy and seizures; neurologic checks and urgent medical review are needed.
C
Sodium and fluid restriction with daily weights are part of ongoing management, but they do not address an acute hypertensive emergency with a severe headache.
D
Antihypertensives need a prescription, and an uncontrolled rapid fall in blood pressure can cause cerebral ischemia; urgent medical review comes first.