A nurse is caring for a client who is at 28 weeks of gestation and received no immunizations during childhood.

Which of the following vaccines should the nurse plan to administer?

Choice A rationale:
Misoprostol is not typically used for preeclampsia management. It’s used for cervical ripening and labor induction.
Choice B rationale:
Assessing for edema is important in a client with preeclampsia as it can indicate a worsening condition.
Choice C rationale:
Restricting daily oral fluid intake is not typically part of the management plan for preeclampsia without severe features.
Choice D rationale:
Administering an IV bolus of lactated Ringer’s is not typically part of the management plan for preeclampsia without severe features.

Choice A rationale:
Hypertension is not a typical symptom of abruptio placentae.
Choice B rationale:
Uterine tenderness is a common symptom of abruptio placentae.
Choice C rationale:
Fetal tachycardia is not a typical symptom of abruptio placentae.
Choice D rationale:
Leukorrhea is not associated with abruptio placentae.

The most likely finding the nurse should expect in a client experiencing abruptio placenta during labor is:

b. Uterine tenderness.

Here's why:

• Hypertension (a):While preeclampsia can increase the risk of abruptio placenta,it's not always present,and hypertension wouldn't be the immediate expected finding during the abruption event itself.
• Fetal tachycardia (c):This can occur in early stages of abruption to compensate for decreased oxygen supply,but as the abruption becomes more severe,fetal bradycardia is more likely due to oxygen deprivation.
• Leukorrhea (d):This is a white vaginal discharge and has no connection to abruptio placenta.

Uterine tenderness is a characteristic sign of abruptio placenta due to bleeding behind the placenta and irritation of the uterine muscle. This is often accompanied by:

• Vaginal bleeding (bright red or dark)
• Abdominal pain or cramping
• Sudden, ongoing uterine tightening or irritability
• Fetal distress (decreased fetal heart rate movements)

Therefore, option b is the most expected finding in this scenario.

Remember: Early recognition and prompt management of abruptio placenta are crucial for optimal outcomes for both mother and baby. If you suspect abruptio placenta, immediate medical attention is essential.