A nurse onapostpartum unit is caring for a client.

Exhibits

Which of the following provider's prescriptions should the nurse anticipate? Select all that apply?

Rationale for Correct Choices

• Seizures: The client’s BP of 166/110 mm Hg, +3 pitting edema, hyperreflexia (4+), and 3+ proteinuria are hallmark findings of severe preeclampsia, which places the client at high risk for progression to eclampsia (seizures). Cerebral edema and vasospasm associated with preeclampsia can precipitate convulsions if untreated.

• Placental abruption: Severe hypertension causes vasoconstriction and endothelial damage in uteroplacental vessels, predisposing the placenta to premature separation. This can lead to fetal distress, decreased movement, and potential maternal hemorrhage, both consistent with placental abruption risk in preeclampsia.

Rationale for Incorrect Choices

• Hypoglycemia: This condition is not related to preeclampsia; it more commonly occurs in clients with diabetes or from medication effects such as insulin overuse.

• Cervical insufficiency: This condition involves painless cervical dilation leading to preterm birth, unrelated to hypertension or proteinuria.

• Heart failure: Although hypertension increases cardiac workload, the current findings (normal heart rate, no dyspnea, clear lungs) do not indicate heart failure in this client.

Rationale:
A. "I will remain with my child throughout each timeout session.": The purpose of a timeout is to remove the child from stimulation and provide an opportunity to calm down and reflect. Staying with the child during a timeout defeats this purpose, as it may reinforce attention-seeking behaviors instead of encouraging self-regulation.

B. "My child is most likely to correct behaviors when they experience natural consequences.": Allowing children to experience natural consequences helps them learn cause-and-effect relationships and develop responsibility for their actions.

C. "My child will learn rules when we offer rewards for positive behavior instead of verbal praise.": While tangible rewards can be helpful initially, consistent verbal praise is a more effective long-term strategy for reinforcing desired behaviors. It builds intrinsic motivation and encourages the child to repeat good behavior without expecting material rewards.

D. "I will be careful not to ignore it when my child misbehaves.": Ignoring minor attention-seeking behaviors can be an effective discipline strategy, as it prevents reinforcement through attention. Overreacting to small misbehaviors may inadvertently increase their frequency rather than reduce them.