Which of the following findings should a nurse report to the provider for a client who is at 20 weeks of gestation?

Choice A reason: Administering an IV bolus of lactated Ringer’s is not indicated for preeclampsia without severe features, as fluid overload can exacerbate hypertension or pulmonary edema. P ओपेक्शिया involves endothelial dysfunction, and excessive fluids may worsen vascular leakage. Blood pressure and symptom monitoring are prioritized over fluid administration in non-severe cases.

Choice B reason: Misoprostol is used for labor induction or postpartum hemorrhage, not preeclampsia management. Preeclampsia requires blood pressure control and seizure prophylaxis, not cervical ripening agents. Misoprostol’s prostaglandin effects are irrelevant to preeclampsia’s pathophysiology, which involves vasoconstriction and endothelial damage, making this medication inappropriate for the condition’s treatment.

Choice C reason: Assessing blood pressure twice daily is insufficient for preeclampsia, even without severe features, as it requires frequent monitoring (every 4-6 hours) to detect progression to severe hypertension. Preeclampsia can rapidly worsen due to vascular instability, and infrequent checks risk missing critical changes, compromising maternal and fetal safety.

Choice D reason: Assessing for edema is essential in preeclampsia, as it reflects vascular leakage from endothelial dysfunction. Edema, especially in the face or hands, signals worsening disease, necessitating closer monitoring or intervention. This assessment tracks fluid retention, a key pathophysiological feature of preeclampsia, aiding in early detection of progression to severe features.

Choice A reason: Mitral valve stenosis at 28 weeks increases cardiac workload, risking heart failure or arrhythmias due to increased blood volume in pregnancy. However, it does not directly cause seizures. Seizure risk is linked to neurological or hypertensive conditions, not cardiac valvular issues, which primarily affect hemodynamic stability and not seizure thresholds.

Choice B reason: A positive Kleihauer-Betke test at 32 weeks indicates fetal-maternal hemorrhage, requiring Rho(D) immune globulin to prevent isoimmunization. It does not increase seizure risk, as it affects blood compatibility, not neurological stability. Seizures are unrelated to this hematological issue, which primarily impacts future pregnancies rather than maternal neurological function.

Choice C reason: Cystic fibrosis at 30 weeks affects respiratory and pancreatic function, leading to infections or malabsorption, but not seizures. Seizure risk requires neurological or hypertensive triggers, not pulmonary or metabolic issues. The condition’s impact on maternal oxygenation does not directly alter seizure thresholds or neurological excitability in pregnancy.

Choice D reason: Severe chronic hypertension at 36 weeks increases seizure risk due to preeclampsia or eclampsia, where elevated blood pressure disrupts cerebral autoregulation, causing neuronal irritability. Seizure precautions are critical, as hypertension-induced endothelial damage and cerebral edema can trigger convulsions, threatening maternal and fetal safety, necessitating magnesium sulfate prophylaxis.