A 37-year-old woman, gravida 1 para 0, comes to the office for a routine prenatal appointment at 28 weeks of gestation. The pregnancy has been uneventful, and she has been compliant with prenatal care
. During the past week, she has been feeling a severe throbbing headache
, with minimal response to acetaminophen
. Medical history is unremarkable, and she has no history of migraines
. Temperature is 37.0°C (98.6°F), pulse
is 95/min, and blood pressure
is 150/95 mmHg. Review of medical records at 24 weeks of gestation shows blood pressure of 135/80. Which of the following would prompt further evaluation in this patient?