A nurse is caring for a client who is at 36 weeks of gestation.
Which of the following findings should the nurse identify as the priority to assess further?

Choice A rationale

Providing an opportunity to connect with others who have experienced similar losses offers significant psychosocial support. Sharing experiences can normalize grief, reduce feelings of isolation, and validate emotions. This peer support can facilitate the grieving process by fostering a sense of community and understanding during a challenging time.

Choice B rationale

While some causes of spontaneous abortion can be identified, many remain unknown even after the expulsion of fetal tissue. Genetic anomalies, chromosomal abnormalities, or uterine factors are often implicated, but a definitive cause is not always determined. Providing this information can create unrealistic expectations and potential disappointment for the client.

Choice C rationale

The decision to view fetal remains is highly personal and depends on individual coping mechanisms and cultural beliefs. For some, it can be a crucial part of acknowledging the loss and beginning the grieving process. Advising against it prematurely removes a potential avenue for closure and validation for the client.

Choice D rationale

Validating the client's grief, regardless of the gestational age, is crucial for emotional well-being. Acknowledging that it is "okay to feel some grief now" provides permission for the client to experience their emotions. Grief is a subjective process, and the intensity and duration are not dictated by the length of the pregnancy.

Choice A rationale

Assessing blood pressure twice daily is insufficient for a client with preeclampsia postpartum. Preeclampsia can worsen or manifest postpartum, necessitating more frequent monitoring, typically every 4 hours or more depending on the severity, to detect changes indicating progression or resolution of the condition and guide timely intervention.

Choice B rationale

Administering an IV bolus of lactated Ringer's could exacerbate fluid overload in a client with preeclampsia, as these clients often have compromised renal function and increased extracellular fluid. Fluid administration should be carefully managed to avoid pulmonary edema, and boluses are generally avoided unless hypovolemia is clearly indicated.

Choice C rationale

Assessing for edema is crucial postpartum for a client with preeclampsia. Preeclampsia is characterized by widespread endothelial dysfunction, leading to increased vascular permeability and fluid shifts into interstitial spaces. Monitoring edema, particularly in the face and extremities, helps evaluate fluid status and assess the resolution or persistence of the preeclamptic state.

Choice D rationale

Obtaining a prescription for misoprostol is not indicated for the management of preeclampsia without severe features postpartum. Misoprostol is a prostaglandin analog primarily used for cervical ripening, labor induction, or postpartum hemorrhage management due to its uterotonic properties, not for the direct management of hypertension or other preeclamptic symptoms.