A nurse is caring for a client who is pregnant.

Exhibits

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The client is at greatest risk for developing

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and

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.

Seizures: The client’s severe hypertension (BP 166/110 mm Hg), proteinuria (3+), and neurological symptoms (headache) place her at high risk for eclampsia, which is characterized by the onset of seizures in a client with preeclampsia.

Placental abruption: Severe preeclampsia increases the risk of placental abruption, which is the premature separation of the placenta from the uterine wall, especially in clients with high blood pressure.

Parent Statements Reflecting Understanding:

“We should prop the casted arm on pillows for the next 24 hours.” This demonstrates understanding because elevating the casted arm helps reduce swelling, improve circulation, and increase comfort during the initial period after casting. Proper elevation is an essential part of post-cast care.

“It is important that our child avoids placing anything inside the cast.” This shows correct understanding because inserting objects inside the cast can damage the skin, cause irritation, or lead to infection. Avoiding insertion of objects helps protect the skin and maintain safe healing conditions.

“We need to be very careful about how we handle the cast for the first 2 days while it dries.” This reflects understanding because a cast is still soft and vulnerable immediately after application. Gentle handling ensures the cast maintains proper alignment, which is critical for proper bone healing.

“We should notify the provider if the cast becomes loose over time.” This demonstrates understanding because a loose cast can compromise immobilization, potentially leading to improper healing or displacement of the fracture. Notifying the provider ensures timely correction.

Parent Statements Needing Reinforcement:

“We should expect the swelling and tingling to worsen before it gets better.” This statement indicates a misunderstanding. In a properly casted limb, swelling and tingling should gradually improve, not worsen. Worsening symptoms may suggest neurovascular compromise, which is an urgent condition requiring immediate evaluation by a healthcare provider. Parents need reinforcement that persistent or increasing tingling, numbness, pain, or changes in color of the fingers are warning signs and should not be ignored.