A nurse is completing discharge teaching to a client in her 35th week of pregnancy who has mild preeclampsia. Which of the following information about nutrition should be included in the teaching?

Choice A reason:
Administering oxygen via face mask is a common intervention for late decelerations; however, it is not the first-line action. Oxygen is given to improve fetal oxygenation, but repositioning the mother has a more immediate effect on improving uteroplacental blood flow and, consequently, fetal oxygenation12.

Choice B reason:
Increasing the infusion rate of IV fluid is an intervention used to expand maternal blood volume, which can improve placental perfusion. However, this is not the primary action to be taken when late decelerations are noted, as it may take time for the increased fluid to affect the uteroplacental circulation.

Choice C reason:
Elevating the client’s legs can help increase venous return to the heart, potentially improving uteroplacental circulation. Nonetheless, this is not the most immediate action to take for late decelerations, as it does not directly address the potential compression of the vena cava or aorta.

Choice D reason:
Positioning the client on her side, particularly the left side, is the priority nursing action for late decelerations. This position helps relieve pressure on the inferior vena cava, enhancing maternal cardiac output and increasing blood flow to the placenta, which can quickly improve fetal oxygenation and resolve late decelerations

Choice A reason:
In the case of a client with painless, bright red vaginal bleeding at 38 weeks of gestation, the priority is to stabilize the client's condition. Initiating IV access is crucial as it allows for rapid administration of fluids or blood products to address potential hypovolemia and to prepare for the possibility of an emergency cesarean section if needed. The client's low blood pressure and elevated heart rate suggest that she may be experiencing hypovolemia, which can quickly lead to hypovolemic shock if not treated promptly.

Choice B reason:
While obtaining informed consent is important before any surgical procedure, it is not the immediate priority. The priority is to stabilize the client, and consent can be obtained concurrently with other stabilizing actions or by another member of the healthcare team.

Choice C reason:
Inserting an indwelling urinary catheter is a supportive measure that can be necessary during labor or before surgery to keep the bladder empty, reducing the risk of bladder injury during a cesarean section and monitoring urine output as an indicator of renal perfusion. However, it is not the first priority in the presence of significant vaginal bleeding.

Choice D reason:
Preparing the abdominal and perineal areas is part of the preoperative procedure for a cesarean section. This action would follow after the client has been stabilized and a decision for surgery has been made.