A nurse on the labor and delivery unit is assessing four clients.
Which of the following clients is a candidate for an induction of labor with Misoprostol?

Choice A rationale

Reducing fluid intake will not alleviate breast engorgement and may even be detrimental to milk production and overall maternal hydration. Engorgement is caused by increased blood flow and milk production in the breasts, not excess fluid intake.

Choice B rationale

Frequent breastfeeding, ideally every 1-2 hours, helps to remove milk from the breasts, which relieves pressure and engorgement. Regular emptying of the breasts signals the body to regulate milk production and prevents the buildup of milk that causes discomfort and can lead to complications like mastitis.

Choice C rationale

Avoiding the use of a breast pump when breasts are engorged can worsen the condition. A breast pump can be used to express milk and relieve pressure if the infant is not feeding effectively or frequently enough. Complete milk removal is key to reducing engorgement.

Choice D rationale

Skipping feedings will exacerbate breast engorgement as milk will continue to accumulate in the breasts, increasing pressure, pain, and the risk of complications. Regular milk removal is essential for managing engorgement and establishing a healthy breastfeeding pattern.

Choice A rationale

Edema, particularly peripheral edema, is a common clinical sign of preeclampsia. It results from fluid shifts due to increased vascular permeability and decreased plasma protein levels associated with the disease process.

Choice B rationale

Glycosuria, the presence of glucose in the urine, is not typically a symptom of preeclampsia. It is more commonly associated with gestational diabetes, a separate condition of pregnancy characterized by impaired glucose tolerance.

Choice C rationale

Proteinuria, the presence of significant amounts of protein in the urine (typically ≥300 mg in a 24-hour urine collection), is a hallmark sign of preeclampsia. It reflects glomerular endothelial damage and increased permeability.

Choice D rationale

Hypertension, defined as a blood pressure of ≥140/90 mmHg on two separate occasions at least 4 hours apart after 20 weeks of gestation, is a key diagnostic criterion for preeclampsia. It results from systemic vasoconstriction.