A nurse is caring for an adolescent client who is gravida 1, para 0. The client was admitted to the hospital at 38 weeks of gestation with a diagnosis of preeclampsia. Which of the following findings should the nurse identify as inconsistent with preeclampsia?

Choice a reason:
The viability of the fetus at 38 weeks of gestation is typically not the primary concern when heavy, red vaginal bleeding occurs without contractions. Fetal movements reported by the mother are a good sign of fetal well-being. However, the ultrasound in this scenario is more likely to be used to rule out placental issues that could cause bleeding, rather than to assess fetal viability.

Choice b reason:
The biparietal diameter (BPD) is a measurement taken during an ultrasound to assess fetal growth and development. While BPD is an important parameter, it is not typically the focus of an urgent ultrasound in the context of heavy vaginal bleeding late in pregnancy. The BPD is more relevant to growth assessments rather than acute bleeding episodes.

Choice c reason:
Locating the placenta is crucial in the case of heavy, red vaginal bleeding at 38 weeks of gestation. The bleeding could be indicative of placental abruption or placenta previa, both of which are serious conditions that require immediate medical attention. An ultrasound can quickly determine the location of the placenta and assess for these conditions.

Choice d reason:
Assessing fetal lung maturity is not typically the priority in an emergency situation involving heavy vaginal bleeding. While lung maturity is an important consideration for the timing of delivery, especially in preterm labor, the immediate concern in this scenario would be to identify the source of bleeding and ensure the safety of both the mother and fetus.

Choice A Reason:
Peanut butter should be eliminated from the diet of a pregnant client with PKU. It is a high-protein food that contains phenylalanine, an amino acid that individuals with PKU cannot metabolize properly¹. The accumulation of phenylalanine can lead to serious health issues for both the mother and the developing fetus, including the risk of intellectual disability in the child.

Choice B Reason:
Potatoes are generally safe for individuals with PKU to consume. They are not high in protein and thus do not contain large amounts of phenylalanine. However, portion sizes and overall dietary balance should be monitored by a healthcare professional to ensure proper nutrition.

Choice C Reason:
Apple juice is also safe for individuals with PKU. It does not contain protein and therefore is not a significant source of phenylalanine. It can be included in the diet as part of the fluid intake.

Choice D Reason:
Broccoli is a low-protein vegetable and is typically allowed in the diets of individuals with PKU. It contains some phenylalanine, but in much lower amounts compared to high-protein foods. As with all foods, it should be consumed in moderation according to dietary guidelines provided by a healthcare professional.