A nurse is providing teaching at a community health fair about electrical fire prevention. Which of the following information should the nurse include in the teaching?

Rationale for Correct Choices

• Seizures: The client’s BP of 166/110 mm Hg, +3 pitting edema, hyperreflexia (4+), and 3+ proteinuria are hallmark findings of severe preeclampsia, which places the client at high risk for progression to eclampsia (seizures). Cerebral edema and vasospasm associated with preeclampsia can precipitate convulsions if untreated.

• Placental abruption: Severe hypertension causes vasoconstriction and endothelial damage in uteroplacental vessels, predisposing the placenta to premature separation. This can lead to fetal distress, decreased movement, and potential maternal hemorrhage, both consistent with placental abruption risk in preeclampsia.

Rationale for Incorrect Choices

• Hypoglycemia: This condition is not related to preeclampsia; it more commonly occurs in clients with diabetes or from medication effects such as insulin overuse.

• Cervical insufficiency: This condition involves painless cervical dilation leading to preterm birth, unrelated to hypertension or proteinuria.

• Heart failure: Although hypertension increases cardiac workload, the current findings (normal heart rate, no dyspnea, clear lungs) do not indicate heart failure in this client.

Rationale:
A. "Dehydration is caused by a decreased hemoglobin and hematocrit.": Dehydration typically results in increased, not decreased, hemoglobin and hematocrit values because fluid loss concentrates red blood cells. Low values would suggest anemia or blood loss rather than dehydration.

B. "Dehydration is associated with gastroesophageal reflux.": While dehydration may worsen nausea or fatigue, it is not directly linked to gastroesophageal reflux. GERD in pregnancy is usually caused by hormonal relaxation of the lower esophageal sphincter and increased intra-abdominal pressure from the enlarging uterus.

C. "Dehydration is treated with calcium supplements.": Calcium supplements are unrelated to treating dehydration. Management focuses on restoring fluid balance through oral or intravenous hydration to maintain uteroplacental perfusion and reduce uterine irritability.

D. "Dehydration can increase the risk for preterm labor.": Dehydration leads to increased secretion of antidiuretic hormone (ADH), which can stimulate oxytocin release and uterine contractions. Correcting dehydration helps reduce uterine activity and lowers the risk of preterm labor in pregnant clients.