What is the only known cure for preeclampsia?

Choice a) Insert an indwelling urinary catheter is incorrect because this is not a priority action for a client who has a large amount of painless, bright red vaginal bleeding. This type of bleeding is suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervix, preventing normal delivery. Inserting an indwelling urinary catheter can cause trauma to the cervix or the placenta, which can worsen the bleeding and endanger the mother and the fetus. Therefore, this action should be avoided unless absolutely necessary.

Choice b) Prepare the abdominal and perineal areas is incorrect because this is not a priority action for a client who has a large amount of painless, bright red vaginal bleeding. This type of bleeding is suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervix, preventing normal delivery. Preparing the abdominal and perineal areas can be done before performing a cesarean section, which is usually the preferred mode of delivery for placenta previa. However, this action should be done after stabilizing the client's condition and obtaining informed consent for surgery.

Choice c) Witness the signature for informed consent for surgery is incorrect because this is not a priority action for a client who has a large amount of painless, bright red vaginal bleeding. This type of bleeding is suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervix, preventing normal delivery.

Witnessing the signature for informed consent for surgery can be done before performing a cesarean section, which is usually the preferred mode of delivery for placenta previa. However, this action should be done after stabilizing the client's condition and explaining the risks and benefits of surgery.

Choice d) Initiate IV access is correct because this is the priority action for a client who has a large amount of painless, bright red vaginal bleeding. This type of bleeding is suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervix, preventing normal delivery. Initiating IV access can help to restore fluid volume, prevent hypovolemic shock, administer medications such as oxytocin or blood products if needed, and prepare for emergency cesarean section if indicated. Therefore, this action should be done as soon as possible to save the life of the mother and the fetus.

Choice A: This is the correct answer because a hard and tender abdomen is a sign of concealed hemorrhage, which can lead to hypovolemic shock and fetal distress. The nurse needs to monitor the woman's blood loss, blood pressure, pulse, and fetal heart rate to detect any complications and intervene accordingly.

Choice B: This is incorrect because opioid pain medication can mask the signs of shock and fetal distress, and may also cause respiratory depression in both the mother and the fetus. Pain relief should be given after assessing the woman's condition and consulting with the physician.

Choice C: This is incorrect because documenting the findings is not a priority action. The nurse needs to act quickly to prevent further blood loss and fetal compromise, and report the findings to the physician.

Choice D: This is incorrect because relaxation techniques may not be effective in reducing the pain and anxiety caused by abruptio placentae. The nurse should provide emotional support and reassurance to the woman, but also focus on assessing and managing her physical condition.