A nurse is caring for a client who is receiving epidural anesthesia. The client is hypotensive with decreased placental perfusion.
Which of the following actions should the nurse take?

Choice A rationale: Ensuring suction is available is critical because clients with severe preeclampsia or eclampsia are at risk for seizures that can cause airway obstruction from secretions or vomiting. Suction readiness supports immediate airway management during a seizure, preventing aspiration and maintaining oxygenation, essential in protecting maternal and fetal health.

Choice B rationale: Administering 10 L of oxygen via nasal cannula is not appropriate because nasal cannulas typically deliver oxygen up to 6 L/min; higher flows require a different delivery system like a non-rebreather mask. Also, routine high-flow oxygen is not indicated unless hypoxia is present. The client’s oxygen saturation is normal (99%), so supplemental oxygen at this rate is unnecessary and could cause discomfort or drying of mucous membranes.

Choice C rationale: Raising side rails is a safety measure to prevent injury during seizures or sudden movements caused by central nervous system irritability in preeclampsia. Elevated side rails help protect the client from falls or trauma if a seizure occurs, an essential precaution in clients with neurological symptoms such as hyperreflexia and clonus.

Choice D rationale: Placing a padded tongue blade at the bedside prepares for seizure management by preventing tongue biting and airway obstruction. The padded blade reduces the risk of oral trauma during convulsions and maintains airway patency. However, it should be used carefully to avoid airway injury or obstruction and only if a seizure occurs.

Choice E rationale: Dimming lights reduces environmental stimuli that may exacerbate neurological irritability or trigger seizures in preeclampsia/eclampsia. Bright or flashing lights can increase CNS excitation, worsening headache, visual disturbances, or seizure risk. Creating a calm, low-stimulation environment helps stabilize the client’s neurological status.

Choice F rationale: Placing the client in the supine position is contraindicated because it compresses the inferior vena cava, reducing venous return and cardiac output, potentially worsening placental perfusion. The left lateral position is preferred in hypertensive pregnancy to optimize uteroplacental blood flow and maternal hemodynamics, improving fetal oxygenation and maternal comfort.

Step 1 is to determine the number of days from April 1 to December 26. Days in April = 30 - 1 + 1 = 30 days. Days in May = 31 days. Days in June = 30 days. Days in July = 31 days. Days in August = 31 days. Days in September = 30 days. Days in October = 31 days. Days in November = 30 days. Days in December = 26 days. Total number of days = 30 + 31 + 30 + 31 + 31 + 30 + 31 + 30 + 26 = 270 days.

Step 2 is to convert the total number of days into weeks. 270 days ÷ 7 days/week = 38.57 weeks.

Step 3 is to round to the nearest whole week. The anticipated gestational age is 39 weeks.