A nurse is collecting data from a client who is at 26 weeks of gestation and whose last appointment was 1 month ago. Which of the following findings should the nurse report to the provider?

(a) Pedal edema
Pedal edema, or swelling of the feet and ankles, is a common finding during pregnancy due to increased fluid retention and pressure on the lower extremities from the growing uterus. While pedal edema should be monitored, it is not typically a concerning finding unless it is severe or accompanied by other symptoms suggestive of preeclampsia.

(b) BP of 132/84 mm Hg
A blood pressure of 132/84 mm Hg is within the normal range for pregnancy. However, if the client's blood pressure continues to increase or is accompanied by other symptoms of hypertension, such as proteinuria or headaches, it may warrant further evaluation.

(c) Weight gain of 1 kg (2.2 lb)
Weight gain during pregnancy is expected and can vary from person to person and from week to week. A weight gain of 1 kg (2.2 lb) over the course of a month is within the normal range for pregnancy and may not require immediate reporting to the provider unless there are other concerning symptoms.

(d) Double vision
Double vision (diplopia) can be a symptom of several conditions, including preeclampsia, which is a serious complication of pregnancy characterized by high blood pressure and proteinuria. Double vision can also be caused by other neurological or ophthalmologic conditions. Given its potential association with preeclampsia and other serious conditions, the nurse should promptly report double vision to the provider for further evaluation and management.

(A) "I will nurse my baby for 5 to 10 minutes on each breast.":
While nursing for 5 to 10 minutes on each breast might work for some babies, it's generally recommended to allow the baby to nurse as long as they are actively sucking and swallowing. The length of time can vary depending on the baby's needs and the mother's milk supply.

(B) "I will make sure that just the nipple is in my baby's mouth.":
This is incorrect because proper latch-on involves the baby having not just the nipple but also a large portion of the areola in their mouth. This ensures effective milk transfer and helps prevent nipple soreness and damage.

(C) "I will apply vitamin E oil to my nipples after each feeding.":
Applying vitamin E oil or any other substance to the nipples is not typically recommended without the advice of a healthcare provider. Some substances can cause irritation or allergic reactions. Instead, if there is nipple soreness, lanolin or expressed breast milk can be used, but it's best to follow guidelines given by a healthcare provider.

(D) "I will lay my baby on a pillow at the level of my breast.":
Using a pillow to support the baby at the level of the breast can help ensure proper positioning and latch during breastfeeding. This position can make breastfeeding more comfortable for both the mother and the baby, promoting effective feeding and reducing the risk of nipple pain.