A nurse is caring for a client who is 4 hours postpartum following a vaginal birth. The client has saturated a perineal pad within 10 minutes. Which of the following actions should the nurse take first?

Choice A reason:
Continuous fetal monitoring is a standard order for clients with severe preeclampsia. It allows healthcare providers to assess the baby's heart rate pattern, which can indicate how well the baby is tolerating the intrauterine environment. This is particularly important in cases of severe preeclampsia, where there is a risk of fetal distress.

Choice B reason:
Obtaining a daily weight is also a standard practice for clients with severe preeclampsia. Weight gain can be an indicator of worsening preeclampsia due to fluid retention and should be monitored closely. Sudden weight gain can signify increased fluid retention, which may require medical intervention.

Choice C reason:
Assessing deep tendon reflexes every hour is appropriate for clients with severe preeclampsia. Hyperreflexia can be a sign of worsening preeclampsia and impending eclampsia. Frequent monitoring allows for early detection of changes in reflexes, which can be critical in managing the condition.

Choice D reason:
Ambulating twice daily would require clarification because clients with severe preeclampsia are typically advised to have bed rest to lower blood pressure and reduce the risk of complications. Ambulation could increase the risk of hypertensive crisis or other complications, so this order seems contrary to standard management practices for severe preeclampsia.

Choice a reason:
Increasing abdominal pain with a nonrelaxed uterus is not typically indicative of placenta previa. This symptom could suggest other complications such as uterine rupture or placental abruption, which are serious conditions requiring immediate medical attention.

Choice b reason:
Abdominal pain with scant red vaginal bleeding is also not a classic sign of placenta previa. While vaginal bleeding can occur in placenta previa, it is usually not associated with abdominal pain. Pain accompanied by bleeding is more suggestive of other obstetric emergencies.

Choice c reason:
Painless red vaginal bleeding is a hallmark sign of placenta previa. In placenta previa, the placenta covers the cervical os either partially or completely, leading to bleeding when the lower part of the uterus stretches and thins as part of the preparation for labor. This bleeding is typically sudden and painless and can range from light to heavy.

Choice d reason:
Intermittent abdominal pain following the passage of bloody mucus is not characteristic of placenta previa. This symptom could be associated with the normal process of losing the mucus plug as labor approaches or could indicate other conditions but is not specific to placenta previa.