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 38 weeks of gestation and reports a cough and fever.

The client at 38 weeks of gestation with a cough and fever presents with symptoms that could indicate a potential infection, such as respiratory or urinary tract infection, which can be serious during pregnancy. Infections in late pregnancy can also increase the risk of complications for both the mother and the baby. Therefore, assessing this client first is crucial to evaluate and address any potential infection and prevent complications.

B. A client who is at 28 weeks of gestation and reports painless vaginal bleeding.

Painless vaginal bleeding can be a concern, especially in the second or third trimester, as it may indicate conditions such as placenta previa or placental abruption. However, since this client's bleeding is painless, it may not be an immediate emergency compared to the potential infection in option A.

C. A client who is at 14 weeks of gestation and reports nausea and vomiting.

Nausea and vomiting, commonly known as morning sickness, are common during early pregnancy. While these symptoms can be uncomfortable, they are typically not urgent unless they lead to dehydration or other complications, which would require assessment but may not be as urgent as a potential infection in option A.

D. A client who has missed a period and reports vaginal spotting.

Vaginal spotting can occur in early pregnancy and may or may not be concerning depending on the amount and frequency. Since this client has missed a period, it suggests early pregnancy, and spotting can be relatively common in early pregnancy without indicating a significant problem. However, assessment is still needed to rule out any potential complications.

Explanation:

A. "In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone."

This response is accurate and informative. It explains that urinary frequency is a common symptom during early pregnancy due to hormonal changes and pressure on the bladder. It also provides a general timeline by stating that, in most cases, urinary frequency improves by the 12th week as the uterus rises out of the pelvis. Additionally, it mentions that poor bladder tone can contribute to ongoing urinary frequency, acknowledging individual differences.

B. "It occurs during the first trimester and near the end of the pregnancy."

This response is not accurate. While urinary frequency is common during the first trimester due to hormonal changes and pressure on the bladder, it typically improves rather than occurring again near the end of pregnancy. Mentioning both the first trimester and near the end of pregnancy could be confusing and misleading for the client.

C. "There is no way to predict how long it will last in each individual client."

While there can be individual variations in how long urinary frequency lasts during pregnancy, there are general trends and common timelines for this symptom. This response may be seen as somewhat dismissive or uninformative since it does not provide any guidance or context for the client's question.

D. "It's a minor inconvenience, which you should ignore."

This response is not appropriate as it dismisses the client's concerns about urinary frequency. While urinary frequency is a common symptom during pregnancy, it can still be uncomfortable for some individuals, and healthcare providers should acknowledge and address their concerns rather than suggesting they ignore them.