A nurse is collecting information from a new client who is seeking prenatal care.
Which of the following findings should the nurse identify as a risk factor that increases the risk of pregnancy complications?

Choice A rationale

Providing a high-protein diet is beneficial for tissue repair and overall healing, as proteins are essential building blocks for cells and enzymes involved in the inflammatory and reparative processes. However, this intervention is secondary to addressing the underlying infection. Nutritional support optimizes recovery but does not directly eliminate the bacterial pathogen.

Choice B rationale

Encouraging weight-bearing on the affected limb is contraindicated in acute osteomyelitis. This action could exacerbate inflammation, increase pain, and potentially lead to pathological fractures or further dissemination of the infection within the bone, compromising structural integrity and delaying healing. Rest is crucial for minimizing stress on the compromised bone.

Choice C rationale

Administering IV antibiotics as prescribed is the priority intervention because osteomyelitis is a severe bacterial infection of the bone. Intravenous administration ensures high systemic concentrations of antibiotics, reaching the infected bone tissue efficiently to eradicate the pathogen, prevent further bone destruction, and reduce the risk of systemic complications like sepsis.

Choice D rationale

Applying heat packs to the affected area might provide some symptomatic relief from pain by increasing blood flow, but it is not a primary intervention for osteomyelitis. Heat can potentially increase swelling and may not be effective in reaching the deep-seated infection within the bone. Direct antimicrobial therapy is paramount for resolution.

Choice A rationale

Report of insomnia is a common and often expected complaint during the third trimester of pregnancy due to physical discomforts such as frequent urination, fetal movement, and difficulty finding a comfortable position. While bothersome for the client, it is typically not indicative of a serious complication requiring immediate reporting to the provider in a routine prenatal visit.

Choice B rationale

Blood-tinged mucous vaginal discharge, or "bloody show," is a normal finding at 38 weeks of gestation. It indicates cervical changes such as effacement and dilation as the body prepares for labor. This physiological process results from the rupture of small capillaries in the cervix and is expected.

Choice C rationale

A blood pressure of 134/80 mm Hg, while slightly elevated from typical mid-pregnancy readings, is generally within acceptable limits for a 38-week gestation. A normal blood pressure range in pregnancy is typically less than 140/90 mm Hg. This reading alone does not indicate preeclampsia or other hypertensive disorders in the absence of other symptoms.

Choice D rationale

A weight gain of 2.2 kg (4.8 lbs) in one week at 38 weeks of gestation is concerning. Rapid weight gain during pregnancy, particularly in the third trimester, can be a sign of fluid retention and may indicate potential complications such as preeclampsia, a serious hypertensive disorder of pregnancy, and warrants prompt evaluation by the provider. .