A nurse is caring for a client who has preeclampsia and is experiencing a postpartum hemorrhage. The nurse should expect the provider to prescribe which of the following medications?

A. Ask each nurse to take turns making the assignments: This may seem fair, but it avoids addressing the underlying conflict and could lead to inconsistent or biased assignments. It doesn't promote teamwork or long-term resolution.
B. Tell the nurses that the assignments will be more equitable in the future: This is a vague promise that doesn't actively involve the nurses in resolving the conflict. It may not build trust or address the root perception of favoritism.
C. Arrange for the nurses to have as few shifts together as possible: Separating the nurses may reduce short-term tension, but it avoids the issue and fails to improve communication or working relationships between team members.
D. Encourage collaboration between the two nurses when making the assignments: This strategy promotes open communication, mutual understanding, and shared responsibility. It empowers both nurses to contribute to the process and helps build trust and teamwork.

Rationale for Correct Options:

• Preeclampsia is a hypertensive disorder of pregnancy that typically occurs after 20 weeks of gestation. This client has elevated blood pressure (156/96 mm Hg), proteinuria (25 mg/dL), hyperreflexia, headache, right upper quadrant pain, and facial edema—all hallmark signs of preeclampsia.
• Urinalysis shows elevated protein, which is a diagnostic criterion for preeclampsia. Proteinuria is a result of kidney involvement due to endothelial damage from hypertension indicating kidney involvement due to the systemic vascular changes in preeclampsia.

Rationale for Incorrect Options:

• Chorioamnionitis typically presents with maternal fever, uterine tenderness, foul-smelling amniotic fluid, and fetal tachycardia. This client is afebrile and has no signs of intrauterine infection.
• Preterm labor is indicated by cervical changes and regular uterine contractions, neither of which are present. The fetal monitor shows no contractions, and there are no reports of vaginal drainage or pressure.
• Serum WBC count is mildly elevated at 12,500/mm³, which can be normal in pregnancy and does not indicate infection or inflammation in this context.
• Fundal assessment: The fundal height of 29 cm at 30 weeks is within the normal range (+/- 2 cm), so it does not evidence a particular risk.