A nurse is caring for a client who has preeclampsia and is experiencing a postpartum hemorrhage. The nurse should expect the provider to prescribe which of the following medications?

Rationale for Correct Options:

• Preeclampsia is a hypertensive disorder of pregnancy that typically occurs after 20 weeks of gestation. This client has elevated blood pressure (156/96 mm Hg), proteinuria (25 mg/dL), hyperreflexia, headache, right upper quadrant pain, and facial edema—all hallmark signs of preeclampsia.
• Urinalysis shows elevated protein, which is a diagnostic criterion for preeclampsia. Proteinuria is a result of kidney involvement due to endothelial damage from hypertension indicating kidney involvement due to the systemic vascular changes in preeclampsia.

Rationale for Incorrect Options:

• Chorioamnionitis typically presents with maternal fever, uterine tenderness, foul-smelling amniotic fluid, and fetal tachycardia. This client is afebrile and has no signs of intrauterine infection.
• Preterm labor is indicated by cervical changes and regular uterine contractions, neither of which are present. The fetal monitor shows no contractions, and there are no reports of vaginal drainage or pressure.
• Serum WBC count is mildly elevated at 12,500/mm³, which can be normal in pregnancy and does not indicate infection or inflammation in this context.
• Fundal assessment: The fundal height of 29 cm at 30 weeks is within the normal range (+/- 2 cm), so it does not evidence a particular risk.

A. Revise the current policy for catheter care: Policy changes should be based on identified causes and evidence-based practices. Revising procedures without understanding the root causes may lead to ineffective or unnecessary adjustments.
B. Identify possible precipitating factors related to the infections: Conducting a root cause analysis is the first step in addressing a rise in infections. Identifying contributing factors helps determine targeted interventions that will be most effective in reducing catheter-associated infections.
C. Schedule nursing staff training for infection control procedures: While staff education is important, it should follow a thorough assessment of why infections are occurring. Training that is not focused on specific problems may not address the underlying issue.
D. Meet with providers to discuss measures to decrease the infections: Collaboration with providers is useful, but it should come after collecting data and identifying causes. This ensures that discussions are informed and can lead to more strategic interventions.