A nurse is caring for a client diagnosed with preeclampsia and is being treated with magnesium sulfate IV. The client's respiratory rate is 10/min and deep-tendon reflexes are absent. Which of the following actions should the nurse take?

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.

Explanation:

A. Placenta previa:

Placenta previa is a condition where the placenta partially or completely covers the cervix. It typically presents with painless, bright red vaginal bleeding, especially after 20 weeks of gestation. However, it is not usually associated with sudden, continuous abdominal pain. Instead, placenta previa is known for painless bleeding episodes, which can be severe but intermittent. Therefore, placenta previa is less likely to be the cause of the client's sudden abdominal pain and bleeding in this scenario.

B. Incompetent cervix:

Incompetent cervix, also known as cervical insufficiency, is a condition where the cervix begins to dilate and efface prematurely, often leading to preterm birth. While incompetent cervix can result in painless vaginal discharge or light bleeding, it typically does not cause sudden, continuous abdominal pain and significant vaginal bleeding. Additionally, incompetent cervix is more commonly diagnosed earlier in pregnancy, usually in the second trimester. Therefore, it is less likely to be the cause of the client's symptoms in the third trimester.

C. Abruptio placentae:

Abruptio placentae refers to the premature separation of the placenta from the uterine wall before delivery. It is associated with sudden, severe abdominal pain and vaginal bleeding. The bleeding may be concealed (hidden behind the placenta) or external, depending on the degree of separation. Abruptio placentae is a medical emergency that requires prompt intervention to prevent complications for both the mother and fetus. Given the sudden onset of continuous abdominal pain and vaginal bleeding in a client with pregnancy-induced hypertension, abruptio placentae is the most likely complication in this scenario.

D. Prolapsed cord:

Prolapsed cord occurs when the umbilical cord slips through the cervix and becomes compressed during labor or before the presenting part of the fetus. While prolapsed cord can lead to vaginal bleeding, it is not typically associated with continuous abdominal pain. Instead, prolapsed cord may cause fetal distress due to cord compression, which can manifest as abnormal fetal heart rate patterns. However, in this scenario, sudden, continuous abdominal pain is a more prominent symptom, making abruptio placentae a more likely cause.