A nurse is caring for a client who is pregnant.

Exhibits

A nurse is evaluating the client's response to therapy. Which of the following recent assessment findings indicate the client's condition has improved or not changed?
For each recent assessment finding. click to specify if the finding indicates the client’s condition has improved or has not changed. Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.

A. Coordination of care involves organizing and facilitating access to healthcare services across various settings. Arranging an appointment with a mobile health clinic ensures the client receives direct, accessible, and timely care, which is crucial for rural residents.

B. Encouraging self-advocacy supports health promotion, not coordination of care.

C. Providing information about insurance providers is client education, not care coordination.

D. Offering transportation details helps with access, but does not actively coordinate healthcare delivery.

A. Decreased fetal movement is a warning sign of fetal distress or compromised fetal well-being. It may indicate insufficient oxygenation or nutrient delivery due to placental insufficiency, which can occur in complications such as preeclampsia or intrauterine growth restriction. Immediate assessment, such as a non-stress test (NST) or continuous fetal monitoring, is warranted.

B. A severe headache in the third trimester, especially unrelieved by acetaminophen, is a classic symptom of preeclampsia. This occurs due to elevated blood pressure causing cerebral vasospasm or edema. Persistent headache may precede more severe manifestations like visual disturbances, hyperreflexia, or seizures (eclampsia).

C. Trace or mild ketones in urine can occur due to fasting, dehydration, or high metabolic demand during pregnancy. While monitoring is important, in the absence of significant hyperglycemia or diabetic ketoacidosis, urine ketones alone do not indicate an acute prenatal complication.

D. Proteinuria (3+) is one of the diagnostic criteria for preeclampsia. It reflects glomerular injury caused by endothelial dysfunction in hypertensive disorders of pregnancy. Persistent proteinuria combined with high blood pressure requires close monitoring and intervention to prevent maternal and fetal complications.

E. Elevated BP (162/112 mm Hg) is severe and meets the criteria for preeclampsia (≥140/90 mm Hg). Uncontrolled hypertension in pregnancy increases the risk of stroke, placental abruption, fetal growth restriction, and maternal organ damage. Blood pressure must be monitored closely, and antihypertensive therapy may be indicated.

F. Gravida (G3) and parity (P2) provide obstetric history but do not indicate a current complication. High parity may increase risk in general, but it is not an immediate clinical concern for acute prenatal issues.

G. A respiratory rate of 16/min is within normal limits for adults and pregnant women. It does not indicate acute compromise or prenatal complication.