A nurse is providing prenatal teaching about iron to a client who follows a vegetarian diet. The nurse should recommend that the client consume which of the following foods to enhance the absorption of nonheme iron?

Rationale:

A. Close all nearby windows and doors: Containment helps prevent the spread of smoke and flames. Closing doors and windows minimizes oxygen supply to the fire and keeps it from moving into other areas.

B. Use the unit's fire extinguisher to attempt to put out the fire: The final step is to extinguish the fire, but only if it is safe to do so. The nurse should not attempt this before ensuring safety, alerting others, and containing the fire.

C. Transport the client to another area of the nursing unit: The first priority in a fire situation is rescue, removing anyone in immediate danger, especially vulnerable clients who cannot evacuate themselves.

D. Activate the facility's fire alarm system: Once the client is safe, the next step is to alarm the system to alert others in the facility and begin emergency response protocols.

Rationale for correct choices:

• Placental abruption: Hypertension in pregnancy increases the risk of premature separation of the placenta from the uterine wall. In this case, the elevated BP combined with symptoms like right upper quadrant pain and hyperreflexia suggests a potential complication such as placental abruption.
• Hypertension: A blood pressure of 148/94 mm Hg is above the diagnostic threshold for gestational hypertension. When paired with signs like restlessness, headache, and hyperreflexia, it raises concern for preeclampsia, a known risk factor for placental abruption.

Rationale for incorrect choices:

• Placenta previa: Characterized by painless bleeding in the second or third trimester and associated with abnormal placental placement, not hypertension. The client has no bleeding or ultrasound findings consistent with previa.
• Oligohydramnios: Typically linked to fetal or placental insufficiency or rupture of membranes. No findings in this case suggest low amniotic fluid or related complications.
• Spontaneous abortion: This term applies before 20 weeks’ gestation. The client is 30 weeks pregnant with no signs of fetal demise or expulsion, so this condition does not apply.
• Chorioamnionitis: Requires signs of infection such as fever, uterine tenderness, or foul-smelling discharge. The client is afebrile and has clear lung sounds, making infection unlikely.
• Temperature: The recorded temperature is within normal range (37.4°C), so it does not suggest infection or another abnormality requiring urgent follow-up.
• Vomiting: Common in pregnancy and non-specific unless persistent or linked with abnormal labs. Here, it appears as an isolated symptom and does not directly imply risk of abruption.
• Hyperreflexia: While a sign of preeclampsia, it is secondary to hypertension. It supports the presence of a hypertensive disorder but is not the primary cause of abruption.
• Fundal measurement: A fundal height of 29 cm is normal for 30 weeks’ gestation and does not indicate fetal growth restriction or excess fluid that might signal a complication.