A nurse reviews assessment findings.

For each assessment finding, specify if the finding is consistent with a urinary tract infection or preterm labor.

Each finding may support more than one disease process.

A. Pain: Consistent with both urinary tract infection (UTI) and preterm labor. UTI can cause dysuria and pelvic pain, while preterm labor can present with lower abdominal pain or cramping.

B. Vaginal discharge: Consistent with both urinary tract infection and preterm labor. UTI can cause unusual vaginal discharge due to infection, while increased or unusual discharge can be a sign of preterm labor.

C. Temperature: Consistent with urinary tract infection. Fever is a common symptom of UTI due to infection. Preterm labor usually does not involve a fever unless there is an infection present.

Rationale for correct condition: The client presents with a history of chronic hypertension, headache, visual disturbances, upper abdominal discomfort, and elevated blood pressure. Diagnostic results show elevated uric acid, proteinuria, and decreased platelet count. Physical examination reveals facial swelling, trace pitting edema, and hyperreflexia with clonus. These findings indicate preeclampsia, a condition of elevated blood pressure and proteinuria after 20 weeks of gestation. Preeclampsia may lead to severe complications if untreated.

Rationale for actions:

• Administering magnesium sulfate helps prevent seizures associated with severe preeclampsia.
• Preparing for immediate delivery is necessary if preeclampsia poses a severe risk to the mother or fetus.

Rationale for parameters:

• Monitoring blood pressure trends is crucial to manage and prevent severe hypertensive complications.
• Checking platelet count helps detect worsening coagulopathy, which is common in preeclampsia.

Rationale for incorrect conditions:

• Gestational hypertension: It lacks proteinuria and does not fully account for symptoms like severe headache and visual disturbances.
• HELLP syndrome: Although it shares similarities, HELLP would present with more severe hemolysis and liver involvement.
• Placental abruption: This condition would present with vaginal bleeding and abdominal pain, which are not reported in this case.