A nurse is caring for a client who is pregnant. The nurse is reviewing the client's medical record.

Exhibits

Select 4 findings that indicate a potential prenatal complication

Rationale:

A. Hypotension: Hypotension is typically associated with decreased preload and low PAWP rather than elevated values. An elevated PAWP reflects increased pressure in the left heart, which does not occur with simple hypotension alone.

B. Hypovolemia: Hypovolemia leads to decreased circulating blood volume, reducing preload and PAWP. It is typically marked by low filling pressures, not elevated wedge pressures.

C. Cardiogenic shock: Although cardiogenic shock can be associated with elevated PAWP due to poor cardiac output and fluid backup, it is not as specific a marker as left ventricular failure, which directly affects PAWP.

D. Left ventricular failure: Elevated PAWP reflects increased pressure in the left atrium and pulmonary circulation, which is a hallmark of left-sided heart failure. This elevation occurs because the failing left ventricle cannot efficiently pump blood forward.

Rationale:

A. The client advances the walker and takes a step towards it: This is the correct technique for using a walker. The client should move the walker a short distance ahead, then step into it one foot at a time, maintaining balance and stability throughout the motion.

B. The client grasps the walker by the hand grips on the upper bars: Holding the walker by its designated hand grips is safe and appropriate. This ensures proper control of the device and minimizes the risk of slipping or tipping.

C. The client lifts the walker as it is moved forward: Walkers should be lifted and placed rather than dragged to maintain balance and prevent tripping. This action demonstrates proper use and helps maintain floor contact with all legs of the walker.

D. The client takes multiple steps while holding the walker: Taking multiple steps without first advancing the walker compromises balance and increases the risk of falling. The correct method involves moving the walker first, then taking one step at a time toward it.