A client had unprotected intercourse 2 days ago and does not want to become pregnant. What intervention should the nurse recommend?

The management of preeclampsia at a pre-viable or early preterm gestation focuses on expectant management to allow for fetal growth. This involves close monitoring for maternal end-organ damage while maximizing the time the fetus remains in utero. The strategy balances maternal safety against the risks of neonatal prematurity.

A. Stop fetal growth: Preeclampsia often causes placental insufficiency, which may lead to intrauterine growth restriction (IUGR). However, the goal of medical care is to optimize perfusion and support growth, not to stop it. Fetal biophysical profiles are used to monitor growth.

B. Prolong pregnancy safely: At 28 weeks, the neonate faces significant morbidity from prematurity. Clinicians attempt to maintain the pregnancy to reach a more mature gestational age while blood pressure is controlled. Stabilization prevents acute maternal complications while the fetus gains weight.

C. Immediate delivery: Delivery is the only definitive cure for preeclampsia, but at 28 weeks, it is reserved only for "severe features" that are life-threatening. If the mother and fetus are stable, immediate delivery is avoided to prevent extreme neonatal complications. Delay allows for steroid administration.

D. Eliminate BP monitoring: Frequent blood pressure assessment is the most critical component of managing preeclampsia. Monitoring detects hypertensive crises and guides the administration of antihypertensive medications like labetalol. Eliminating this would lead to unmonitored vasospasm and stroke risk.

Proper gestational nutrition involves balancing increased caloric requirements with food safety practices to avoid foodborne pathogens. Pregnant clients must manage their intake of stimulants and fluids to maintain amniotic fluid levels and maternal homeostasis. Avoiding teratogenic contaminants is a primary goal of prenatal counseling.

A. Increase calories by 300-500 daily: Metabolic demands rise during the second and third trimesters to support tissue synthesis and fetal growth. An additional 300 to 500 kilocalories daily is generally sufficient to achieve the recommended weight gain goals. Excessive intake can lead to gestational diabetes.

B. Drink 8-10 glasses of water: Adequate hydration is necessary to support the expanded vascular system and the production of amniotic fluid. It also helps prevent common pregnancy complications like urinary tract infections and constipation. Proper fluid balance maintains optimal utero-placental perfusion throughout the day.

C. Avoid raw meat: Raw or undercooked meats may harbor Toxoplasma gondii or Listeria monocytogenes, which cause severe congenital infections. These pathogens can cross the placenta and lead to fetal demise or neurological impairment. Ensuring meat is cooked to safe temperatures is essential.

D. Limit caffeine to 200 mg/day: High caffeine intake is associated with vasoconstriction of the uterine arteries and a higher risk of miscarriage. Restricting consumption to less than 200 mg per day minimizes the risk of fetal growth restriction. It helps prevent maternal tachycardia and insomnia.

E. Avoid all dairy: This is incorrect; dairy is a primary source of calcium and protein necessary for pregnancy. Clients should only avoid unpasteurized dairy products, such as soft cheeses, to prevent listeriosis. Pasteurized milk, yogurt, and hard cheeses are highly beneficial for fetal bone health.