A nurse is caring for a client who is in labor at 40 weeks of gestation and reports that she has saturated two perineal pads with blood in the past 30 min. The nurse caring for her suspects placenta previa. Which of the following is an appropriate nursing action?

Choice A reason: Using fingertips when calming the newborn is not recommended, as it can overstimulate the immature nervous system and cause stress. Instead, the nurse should use gentle, firm, and sustained touch, such as cupping the head and feet, or swaddling the newborn.

Choice B reason: Positioning the premature infant on their abdomen is contraindicated, as it can increase the risk of sudden infant death syndrome (SIDS). The nurse should position the newborn on their back or side, with a rolled blanket or towel to support the spine and prevent flattening of the head.

Choice C reason: Keeping the newborn in a well-lit nursery is not advisable, as it can interfere with the development of the circadian rhythm and sleep patterns. The nurse should provide a dark and quiet environment for the newborn, and expose them to natural light during the day.

Choice D reason: Clustering the newborn's care activities is beneficial, as it can reduce the number of disruptions and allow for longer periods of rest and growth. The nurse should plan and coordinate the care activities, such as feeding, bathing, changing, and assessing, to minimize the stress on the newborn.

Choice A reason: Disseminated intravascular coagulation (DIC) syndrome is not the correct answer, as it is a coagulation disorder that causes widespread clotting and bleeding in the body. DIC can occur as a complication of severe preeclampsia, but it is not indicated by the laboratory results. DIC would cause a low platelet count, but also a prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), and a low fibrinogen level.

Choice B reason: Eclampsia is not the correct answer, as it is a seizure disorder that occurs in clients with severe preeclampsia. Eclampsia can occur as a complication of severe preeclampsia, but it is not indicated by the laboratory results. Eclampsia would cause a high blood pressure, but also a proteinuria, edema, and hyperreflexia.

Choice C reason: Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome is the correct answer, as it is a variant of severe preeclampsia that affects the blood and the liver. HELLP syndrome is indicated by the laboratory results, as it causes a low platelet count, an elevated AST level, and a falling hematocrit. HELLP syndrome would also cause a high blood pressure, a proteinuria, and a right upper quadrant pain.

Choice D reason: Idiopathic thrombocytopenia is not the correct answer, as it is an autoimmune disorder that causes the destruction of platelets by antibodies. Idiopathic thrombocytopenia can affect pregnant women, but it is not related to severe preeclampsia or the laboratory results. Idiopathic thrombocytopenia would cause a low platelet count, but not an elevated AST level or a falling hematocrit.