The nurse at a prenatal clinic is preparing to care for a client who is in their first trimester of pregnancy.
Which statement(s) by the client could the nurse expect? (Select all that apply)

The clinical scenario involves a high-risk pregnancy complicated by preeclampsia or HELLP syndrome. Knowledge of maternal-fetal assessment, seizure prophylaxis, and critical laboratory values is necessary to prioritize interventions that ensure hemodynamic stability and prevent eclampsia or placental abruption in the client.

Choice A rationale

Laboratory results in preeclampsia often show elevated liver enzymes, low platelets (normal 150,000 to 400,000/mm), and proteinuria. Communicating these critical values to the provider is essential for timely medical management, potentially leading to delivery or medication adjustments.

Choice B rationale

Oxygen supplementation ensures adequate maternal arterial oxygen saturation, which directly affects fetal oxygenation via placental perfusion. Maintaining high maternal oxygen levels is vital when the client experiences respiratory compromise or during acute hypertensive crises to prevent fetal hypoxia.

Choice C rationale

Continuous fetal heart rate monitoring provides real-time data on fetal well-being and placental function. In high-risk conditions like preeclampsia, it helps detect late decelerations or decreased variability, which indicate fetal distress or chronic uteroplacental insufficiency requiring intervention.

Choice D rationale

Magnesium sulfate is the primary pharmacological intervention for preventing tonic-clonic seizures in clients with severe preeclampsia. It acts as a central nervous system depressant and neuromuscular blocker, reducing neuronal irritability and the risk of eclampsia development..

Differentiating between true and false labor involves assessing physical changes in the reproductive system. Nurses must apply knowledge of cervical effacement and dilation. True labor is defined specifically by progressive changes in the cervix regardless of contraction patterns.

Choice A rationale

Lightening occurs when the fetal head descends into the pelvic inlet, often happening weeks before labor in primigravidas. While it indicates readiness for labor, it does not confirm that active, true labor has actually begun.

Choice B rationale

False labor contractions, or Braxton Hicks, often diminish with activity or position changes. While this assessment provides subjective data about the nature of the discomfort, it is not a definitive diagnostic indicator of true labor.

Choice C rationale

Contraction frequency and intensity can be regular in both true labor and prodromal labor. Relying solely on the timing of contractions is less reliable than physical evidence of cervical progress when diagnosing active labor.

Choice D rationale

The hallmark of true labor is progressive cervical effacement and dilation. Assessing the cervix through a manual exam provides objective evidence that the uterine contractions are effective and that the birthing process is definitively underway.