A nurse is caring for a client who experienced a vaginal birth 12 hours ago. The nurse recognizes the client is in the dependent, taking-in phase of maternal postpartum adjustment. Which of the following findings should the nurse expect during this phase?

Choice A reason:
Urinary frequency typically begins early in pregnancy due to hormonal changes and increased blood volume leading to more fluid being processed by the kidneys and ending up in the bladder. While it often improves in the second trimester as the uterus rises into the abdominal cavity, poor bladder tone is not typically cited as a reason for its continuation.

Choice B reason:
While urinary frequency can be seen as a minor inconvenience, it should not be ignored. It is a normal physiological change during pregnancy. However, if it is accompanied by pain, burning, or any other symptoms, it could indicate a urinary tract infection, which requires medical attention.

Choice C reason:
There is some predictability to urinary frequency in pregnancy. It often starts in the first trimester, improves in the second, and may return in the third trimester as the growing baby and uterus exert pressure on the bladder.

Choice D reason:
This choice is accurate. Urinary frequency is common in the first trimester due to hormonal changes and the growing uterus pressing on the bladder. It often returns in the third trimester when the baby "drops" and the head presses on the bladder. This is a normal part of pregnancy and usually does not indicate any complications.

Choice a reason:
Elevated blood pressure is a primary indicator for preeclampsia, which is a condition characterized by hypertension and often proteinuria after 20 weeks of gestation. The criteria for hypertension in pregnancy are a systolic blood pressure of 140 mm Hg or higher or a diastolic blood pressure of 90 mm Hg or higher on two occasions at least 4 hours apart. If a pregnant client presents with elevated blood pressure, it is crucial for the nurse to initiate further evaluation for preeclampsia, as this condition can lead to serious complications for both the mother and the fetus.

Choice b reason:
Joint pain is not a typical sign of preeclampsia. While joint pain can be a symptom experienced during pregnancy due to various physiological changes, it is not specifically associated with preeclampsia and does not warrant further evaluation for this disorder on its own.

Choice c reason:
Vaginal discharge during pregnancy is common and can vary in consistency and amount. It is not a specific indicator of preeclampsia unless accompanied by other symptoms such as elevated blood pressure or proteinuria. Normal vaginal discharge is usually clear or milky white and does not indicate the need for preeclampsia evaluation.

Choice d reason:
Increased urine output is not typically associated with preeclampsia. In fact, preeclampsia can sometimes lead to reduced urine output due to kidney impairment. If a client has increased urine output, it may be due to other factors such as increased fluid intake or gestational diabetes.