A nurse is assisting with the care of a client who is pregnant.

The nurse is reviewing the client's medical record.

Select the 4 findings that the nurse should identify as a potential prenatal complication.

Pregnancy complications such as hypertensive disorders require prompt recognition because they can rapidly progress to conditions like preeclampsia and threaten both maternal and fetal well-being. Key warning signs include severe hypertension, proteinuria, neurological symptoms, and decreased fetal movement, which may indicate uteroplacental insufficiency. These findings reflect end-organ involvement and impaired placental perfusion. Early identification allows timely intervention to prevent severe maternal and fetal outcomes.

Rationale:

A. Decreased fetal activity is a significant concern in pregnancy as it may indicate reduced uteroplacental perfusion and fetal hypoxia. In hypertensive disorders, placental blood flow can be compromised, leading to decreased fetal movement. This requires immediate follow-up because it may signal fetal distress.

B. Urine protein of 3+ indicates significant proteinuria, which is a key diagnostic feature of preeclampsia. This reflects endothelial damage and increased glomerular permeability associated with hypertensive disorders of pregnancy. It is a critical finding requiring urgent evaluation and monitoring.

C. Severe headache unrelieved by acetaminophen is a concerning neurological symptom associated with severe preeclampsia. It suggests cerebral vasospasm or increased intracranial pressure. This requires immediate follow-up because it may precede complications such as eclampsia or stroke.

D. Gravida 3 para 2 indicates obstetric history but does not represent an acute clinical complication in the current pregnancy. It provides background risk information, but it does not reflect a current abnormal finding requiring urgent intervention.

E. Blood pressure of 162/112 mm Hg is severely elevated and consistent with hypertensive disorder of pregnancy. This level significantly increases risk for maternal complications such as stroke, placental abruption, and organ dysfunction. It requires immediate intervention and close monitoring.

F. Respiratory rate of 16/min is within normal limits and does not indicate respiratory compromise. There is no evidence of distress or abnormal respiratory pattern in this finding. It is not related to the suspected prenatal complication.

G. Urine ketones are negative, indicating no significant fat metabolism or starvation state. This is a normal finding and does not suggest a pregnancy-related complication. Therefore, it does not require follow-up.