A nurse is providing care for a client who is scheduled for electroconvulsive therapy. Which of the following conditions should the nurse identify as an increased risk for complications?

Rationale:
A. Transfer on the client's weaker side when moving a client from a bed to a chair: Clients should be moved toward their stronger side to facilitate participation and reduce strain on both the client and the nurse. Transferring toward the weaker side increases risk of injury and reduces stability.

B. Raise the head of the bed when transferring a client from a bed to a stretcher: Raising the head of the bed does not directly enhance safe body mechanics or ergonomic principles during a transfer. Proper lifting techniques and devices are more critical for preventing injury.

C. Use a lateral transfer device when moving a client from a bed to a stretcher: Using a lateral transfer device, such as a sliding board or transfer sheet, minimizes manual lifting, reduces musculoskeletal strain, and follows ergonomic principles. It is a key safety strategy for both the client and healthcare staff.

D. Use a pillow underneath the client's head when repositioning a client in bed: Placing a pillow under the head supports comfort and alignment but does not relate to ergonomic principles or safe lifting techniques. Ergonomics focuses on body mechanics, positioning, and injury prevention for caregivers.

Rationale:
A. Fetal activity: Decreased fetal movement is an abnormal finding suggesting possible fetal distress or hypoxia. It indicates reduced oxygen or nutrient delivery to the fetus, often associated with maternal complications such as hypertension or preeclampsia. Immediate evaluation with fetal monitoring or ultrasound is warranted.

B. Urine ketones: The absence of urine ketones is expected and does not indicate a prenatal complication. Ketones would only be concerning if elevated, as they could signal dehydration, starvation, or poorly controlled diabetes, which is not present in this case.

C. Urine protein: The presence of 3+ protein in the urine is a key indicator of preeclampsia. Proteinuria results from endothelial damage in the kidneys caused by hypertension, leading to leakage of protein into the urine and confirming a serious pregnancy complication.

D. Report of headache: A severe, persistent headache unrelieved by acetaminophen suggests cerebral vasospasm related to preeclampsia. It reflects increased blood pressure affecting cerebral circulation and can precede seizures or eclampsia if untreated.

E. Respiratory rate: A respiratory rate of 16/min is within the normal range for adults and does not indicate a prenatal complication. There is no evidence of respiratory distress or metabolic abnormality in this finding.

F. Blood pressure: A reading of 162/112 mm Hg meets the diagnostic criteria for severe hypertension in pregnancy and strongly indicates preeclampsia. Uncontrolled elevated blood pressure increases the risk of seizures, placental abruption, and fetal growth restriction.

G. Gravida/parity: Being G3 P2 with one preterm birth is useful background information but not, by itself, a sign of a current complication. It helps identify obstetric history and risk factors but does not reflect an immediate prenatal concern in this assessment.