A nurse is verifying informed consent for a client who is preoperative for a vaginal hysterectomy. Which of the following statements should the nurse identify as an indication that the client has given informed consent?

Post-cesarean pain management includes both pharmacological and nonpharmacological strategies to reduce discomfort while promoting mobility and recovery. Movement such as turning, sitting, and ambulating can increase incision-related pain due to abdominal muscle strain and pressure on the surgical site. Nursing interventions focus on supporting the incision, minimizing tension on sutures, and encouraging early mobilization to prevent complications like venous thromboembolism and atelectasis. Effective teaching improves comfort and participation in postoperative care.

Rationale:
A. Advising the client to change positions as little as possible is incorrect because limited mobility increases the risk of complications such as deep vein thrombosis, pulmonary atelectasis, and delayed healing. Early and frequent position changes are essential after cesarean birth, and pain should be managed to facilitate movement rather than restrict it.

B. Splinting the incision with a pillow during movement is correct because it provides external support to the abdominal incision, reducing tension on the surgical site and decreasing pain during position changes. This technique helps stabilize the area and allows safer, more comfortable mobility after a cesarean birth. It is a commonly recommended nonpharmacological intervention following procedures such as Cesarean section.

C. Applying counterpressure to the back is not appropriate for incision-related pain management after a cesarean birth. This technique is typically used during labor for back pain relief and does not address abdominal surgical discomfort. It does not reduce strain on the incision site during movement.

D. Patterned-paced breathing is primarily used during labor to manage contractions and anxiety. It is not effective for managing postoperative incision pain during position changes. While it may help with relaxation, it does not provide mechanical support or reduce abdominal tension.

Assessment of a pregnant client at 31 weeks gestation requires rapid identification of findings suggestive of hypertensive disorders of pregnancy, particularly Preeclampsia. This condition is characterized by new-onset hypertension, proteinuria, and end-organ involvement that can affect both maternal and fetal well-being. Severe features such as persistent headache and reduced fetal movement indicate possible cerebral and placental compromise. Early recognition is essential to prevent progression to eclampsia, placental abruption, or fetal distress.

Rationale:
A. A blood pressure of 162/112 mmHg is severely elevated and is a defining feature of preeclampsia with severe features. This level of hypertension indicates significant vascular resistance and endothelial dysfunction associated with pregnancy-related hypertensive disorders. It places the client at risk for stroke, organ damage, and placental insufficiency requiring urgent intervention.

B. A severe headache unrelieved by acetaminophen is a concerning neurological symptom associated with worsening preeclampsia. It may indicate cerebral edema, vasospasm, or increased intracranial pressure. Persistent headache in this context is considered a warning sign of progression toward eclampsia and requires immediate evaluation.

C. Urine protein 3+ indicates significant proteinuria, which is a key diagnostic criterion for preeclampsia. This finding reflects glomerular endothelial damage leading to increased protein leakage into urine. The severity of proteinuria correlates with disease progression and maternal-fetal risk.

D. A respiratory rate of 16/min is within normal limits for pregnancy and does not indicate respiratory compromise. There are no associated signs of respiratory distress such as dyspnea or hypoxia. Therefore, this finding is not suggestive of a prenatal complication in this scenario.

E. Urine ketones are negative, indicating no evidence of starvation ketosis or metabolic imbalance. This finding is not associated with hypertensive pregnancy complications and does not suggest maternal or fetal risk in this context.

F. Decreased fetal movement is a significant warning sign of potential fetal compromise due to reduced placental perfusion. In hypertensive disorders like preeclampsia, vasoconstriction can impair oxygen and nutrient delivery to the fetus. This requires immediate fetal assessment to rule out distress.

G. Gravida 3 para 2 with one preterm birth is part of obstetric history but does not represent an acute prenatal complication. While it may indicate a slightly increased baseline risk for preterm delivery, it is not a current pathological finding requiring immediate intervention in this presentation.