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The nurse is continuing to care for the client.

Drag words from the choices below to fill in each blank in the following sentence.

The client is at greatest risk for developing

and 

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C"}

Rationale for correct choices

• Seizures: The client presents with severe hypertension (BP 162/112 mm Hg and 166/110 mm Hg), +3 pitting edema, and proteinuria (3+), which are classic indicators of severe preeclampsia. These factors place the client at high risk for eclampsia, which manifests as seizures during pregnancy. Close monitoring and early intervention are critical to prevent maternal and fetal complications.

• Placental abruption: Severe hypertension and preeclampsia increase the risk of placental abruption, a condition in which the placenta separates prematurely from the uterine wall. This can compromise fetal oxygenation and lead to significant maternal bleeding. The client’s elevated blood pressure, edema, and decreased fetal movement indicate a higher likelihood of this obstetric emergency.

Rationale for incorrect choices

• Heart failure: Although hypertension and fluid shifts in preeclampsia can strain the heart, there is no current evidence of pulmonary edema, dyspnea, or heart failure symptoms in this client. Heart failure is a less immediate risk compared with seizures and placental abruption in the context of severe preeclampsia.

• Hypoglycemia: There is no indication of low blood glucose in the client; laboratory results show glucose within normal limits (85 mg/dL). Hypoglycemia is not a typical complication of preeclampsia and is therefore not an immediate concern in this scenario.

• Cervical insufficiency: Cervical insufficiency typically presents earlier in gestation with painless dilation and risk of preterm birth, rather than in a 31-week client with hypertensive complications. The client’s symptoms of headache, edema, and proteinuria do not indicate cervical insufficiency.


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Related Questions

Correct Answer is C

Explanation

A. The client's activity level: Physical activity is a modifiable risk factor because the client can increase exercise to reduce cardiovascular risk. Lifestyle changes in activity level can significantly impact heart health and recovery after a myocardial infarction.

B. The client's stress level: Stress is a modifiable risk factor as clients can employ stress-reduction techniques, counseling, or lifestyle modifications to lower cardiovascular risk. Managing stress can improve both short-term and long-term cardiac outcomes.

C. The client's race: Race is a nonmodifiable risk factor because it is inherent and cannot be changed. Certain racial and ethnic groups have a higher prevalence of cardiovascular disease due to genetic, socioeconomic, and health access factors.

D. The client's diet: Diet is a modifiable risk factor since clients can adjust their nutritional intake to reduce cholesterol, blood pressure, and overall cardiovascular risk. Nutritional counseling is often part of post-MI care to improve outcomes.

Correct Answer is D

Explanation

A. Dietitian: While nutrition can play a role in overall health and inflammation management, a dietitian referral is not the primary intervention for rheumatoid arthritis. Dietary counseling may be considered adjunctively but is not central to preserving joint function.

B. Case manager: A case manager helps coordinate care and resources, which may be helpful for complex cases, but referral is not specifically targeted to managing the functional impairments associated with rheumatoid arthritis.

C. Podiatrist: A podiatrist is consulted if the client develops foot or ankle complications. Routine referral is not indicated unless specific joint issues are present in the lower extremities.

D. Physical therapist: Physical therapy is essential in rheumatoid arthritis care to maintain joint mobility, reduce pain, and prevent deformities. A physical therapist develops individualized exercise programs, educates on joint protection, and supports functional independence, making this referral highly appropriate.

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