If a pregnant patient presents with nausea, epigastric discomfort, and a blood pressure of 140/90 mm Hg, what is the best next step if her urine dip is negative for protein?

The best next step is to consider her symptoms benign due to a stomach virus. In pregnant patients, the combination of nausea and epigastric discomfort can often be linked to common conditions unrelated to hypertension or preeclampsia, particularly in the absence of protein in the urine.

The threshold for diagnosing preeclampsia includes elevated blood pressure along with the presence of protein in the urine. Since her urine dip test is negative for protein, this indicates that proteinuria, which is a significant marker for preeclampsia, is not present.

Additionally, while hypertension in pregnancy warrants careful evaluation, in this scenario, both her blood pressure reading (140/90 mm Hg) and symptoms do not immediately imply a severe condition if the patient is otherwise stable and shows no signs of other complications. Therefore, considering the benign nature of her symptoms allows for a more cautious and appropriate approach, avoiding unnecessary interventions.

Monitoring symptoms and assessing them in a follow-up appointment would also be prudent in ensuring the well-being of both the mother and the fetus, mitigating risks associated with potential misdiagnosis.