A nurse is admitting a client who has a diagnosis of preterm labor. The nurse anticipates an order by the provider for which of the following medications?

Choice A reason: "I'll basically follow the same diet that I was following before I became pregnant." is an incorrect statement, because it indicates that the client does not understand the need for dietary changes during pregnancy. The client should follow a diet that is individualized, balanced, and consistent in carbohydrate intake, and that meets the nutritional needs of pregnancy.

Choice B reason: "Because I need extra protein, I'll have to increase my intake of milk and meat." is an incorrect statement, because it indicates that the client does not understand the role of protein in diabetes management. The client should consume adequate but not excessive amounts of protein, and choose lean sources of protein, such as poultry, fish, eggs, and legumes.

Choice C reason: "I'll adjust my diet and insulin based on the results of my urine tests for glucose." is an incorrect statement, because it indicates that the client does not understand the limitations of urine tests for glucose. The client should monitor her blood glucose levels regularly, and adjust her diet and insulin accordingly, under the guidance of the provider. Urine tests for glucose are not accurate or reliable indicators of blood glucose levels.

Choice D reason: "Pregnancy affects insulin production, so I'll need to make adjustments in my diet." is a correct statement, because it indicates that the client understands the impact of pregnancy on diabetes. The client should be aware that pregnancy can cause insulin resistance, especially in the second and third trimesters, and that her diet may need to be modified to achieve optimal glycemic control.

Choice A reason: Disseminated intravascular coagulation (DIC) syndrome is not the correct answer, as it is a coagulation disorder that causes widespread clotting and bleeding in the body. DIC can occur as a complication of severe preeclampsia, but it is not indicated by the laboratory results. DIC would cause a low platelet count, but also a prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), and a low fibrinogen level.

Choice B reason: Eclampsia is not the correct answer, as it is a seizure disorder that occurs in clients with severe preeclampsia. Eclampsia can occur as a complication of severe preeclampsia, but it is not indicated by the laboratory results. Eclampsia would cause a high blood pressure, but also a proteinuria, edema, and hyperreflexia.

Choice C reason: Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome is the correct answer, as it is a variant of severe preeclampsia that affects the blood and the liver. HELLP syndrome is indicated by the laboratory results, as it causes a low platelet count, an elevated AST level, and a falling hematocrit. HELLP syndrome would also cause a high blood pressure, a proteinuria, and a right upper quadrant pain.

Choice D reason: Idiopathic thrombocytopenia is not the correct answer, as it is an autoimmune disorder that causes the destruction of platelets by antibodies. Idiopathic thrombocytopenia can affect pregnant women, but it is not related to severe preeclampsia or the laboratory results. Idiopathic thrombocytopenia would cause a low platelet count, but not an elevated AST level or a falling hematocrit.