A nurse in an obstetric clinic is assisting in the care of a 34-year-old female client at 34 weeks of gestation who presents for a routine prenatal visit.

Exhibits

Which of the following findings should the nurse report to the primary health care provider?

Choice A rationale: Platelet count: A platelet count of 95,000/mm³ is significantly below the normal range (150,000–400,000/mm³). Thrombocytopenia can indicate HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelet count), which is a severe complication of preeclampsia that requires immediate medical attention.

Choice B rationale: Hematocrit value: Although the hematocrit value of 35.9% is within the normal range for pregnant women, it is on the higher end. However, this is not an urgent abnormal finding, so it does not require immediate reporting.

Choice C rationale: Nonstress test result: The question does not provide any information about a nonstress test result. Therefore, this choice is not applicable.

Choice D rationale: Weight gain: The client's weight has increased by 2 kg (4.4 lb) in two weeks, which is more than the recommended 0.5 kg (1 lb) per week during the third trimester. Sudden and significant weight gain can indicate fluid retention related to preeclampsia.

Choice E rationale: Edema: The client has progressed from 1+ to 2+ nonpitting edema in the feet and ankles and now has mild facial edema, along with sudden swelling of the fingers. These symptoms are concerning for preeclampsia and should be reported.

Choice F rationale: Blood pressure: A blood pressure reading of 160/100 mm Hg is significantly elevated and diagnostic of hypertension. In the context of the client's other symptoms, it is highly indicative of preeclampsia, which requires prompt intervention.

Choice G rationale: BUN: The question does not provide any information about the blood urea nitrogen (BUN) level. Therefore, this choice is not applicable.

Choice H rationale: Urine protein: The presence of 2+ protein in the urine indicates proteinuria, which is a hallmark sign of preeclampsia. This finding should be reported immediately.