A nurse is admitting a client who is at 37 weeks of gestation and diagnosed with severe gestational hypertension. Which of the following actions should the nurse expect to implement? (Select all that apply.)

Explanation:

A. A client who is at 28 weeks of gestation and receiving terbutaline reports fine tremors:

Fine tremors are a known side effect of terbutaline, which is often used to delay preterm labor by relaxing the uterus. While tremors are a common and expected side effect of terbutaline, they are not typically considered an urgent concern unless they are severe or accompanied by other concerning symptoms.

B. A client who has a diagnosis of preeclampsia has 2+ proteinuria and 2+ patellar reflexes:

Proteinuria (2+) and increased deep tendon reflexes (2+) are significant findings in a client with preeclampsia, indicating worsening of the condition and potential organ involvement. However, they may not require immediate reporting unless accompanied by other severe symptoms such as severe hypertension, severe headache, visual disturbances, or epigastric pain.

C. A client who has a diagnosis of preeclampsia reports epigastric pain and unresolved headache:

This is the correct answer. Epigastric pain and unresolved headache are concerning symptoms in a client with preeclampsia and can indicate worsening of the condition or complications such as HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count). These symptoms may suggest liver involvement, which is a serious complication of preeclampsia and requires immediate evaluation and management by the provider.

D. A tearful client who is at 32 weeks of gestation and is experiencing irregular, frequent contractions:

While tearfulness and irregular, frequent contractions may indicate emotional distress or early labor, they are not typically considered urgent findings unless accompanied by other signs of impending preterm labor such as cervical changes or regular, painful contractions. Immediate reporting is important if there are signs of active labor or cervical changes, but based on the information provided, this finding is not as urgent as the epigastric pain and unresolved headache in a client with preeclampsia.

Explanation:

A. Women during labor and birth:

Maternity nursing does involve caring for women during labor and birth. Nurses in labor and delivery units provide support, monitoring, and assistance to women as they progress through labor and deliver their babies. This aspect of maternity nursing focuses specifically on the care of women during the active stages of childbirth, including pain management, labor progression, and ensuring a safe delivery experience.

B. Mothers and fathers during hospitalization for childbirth:

Maternity nursing also involves caring for both mothers and fathers during their hospitalization for childbirth. Nurses provide education, support, and assistance to new parents as they adjust to the postpartum period and learn to care for their newborns. This includes teaching about newborn care, breastfeeding support, postpartum recovery, and emotional support for the entire family unit.

C. Families during the childbearing process:

This choice is the most comprehensive and accurate description of the client focus in maternity nursing. Maternity nursing encompasses care for entire families during the entire childbearing process, from preconception to postpartum. This includes providing education, support, and guidance to expectant parents, assisting with childbirth, promoting bonding and attachment between parents and newborns, and addressing the physical and emotional needs of the family as they navigate the transitions of pregnancy, childbirth, and early parenthood.

D. Childbearing women during acute illness:

While maternity nursing does involve caring for childbearing women during periods of acute illness related to pregnancy or childbirth complications, this focus is more limited compared to the broader scope of caring for families throughout the entire childbearing process. Maternity nurses may be involved in managing complications such as preeclampsia, gestational diabetes, or postpartum hemorrhage, but their role extends beyond acute illness management to include comprehensive prenatal, intrapartum, and postpartum care for women and their families.