The nurse is continuing to care for the client.

The nurse is reviewing the assessment findings.

For each assessment finding, click to specify if the finding is consistent with preeclampsia or HELLP syndrome. Each finding may support more than one disease process.

A. Teach the client to use compression stockings: Compression stockings are primarily used to prevent venous thromboembolism and edema, not to relieve osteoarthritis pain. They do not address joint stiffness or muscle discomfort associated with osteoarthritis.

B. Place a moist heating pad over the affected area: Heat therapy helps relax muscles, increase blood flow, and reduce joint stiffness, providing effective non-pharmacological pain relief for osteoarthritis. Moist heat is often preferred because it penetrates deeper into the tissues compared to dry heat.

C. Avoid platelet-rich plasma therapy: Platelet-rich plasma therapy is an invasive treatment option and is not considered a routine non-pharmacological intervention for osteoarthritis pain. Avoidance of this therapy is not a direct pain-relief strategy.

D. Encourage the client to use crutches to ambulate: Crutches are generally not indicated for osteoarthritis pain unless severe weight-bearing restrictions are needed. They do not actively relieve joint pain and may increase fatigue or strain in other areas.

Rationale:

• Deep tendon patellar reflex: The client’s patellar reflex decreased from 4+ on day 1 to 2+ on day 2, indicating reduced hyperreflexia. This suggests a positive response to antihypertensive and preeclampsia management, lowering the risk for complications such as eclampsia or seizures.

• Heart rate: The client’s heart rate increased slightly from 84/min on day 1 to 90/min on day 2, which falls within a normal physiologic range and does not indicate significant improvement or deterioration. This shows that cardiovascular status has remained relatively stable.

• Blood pressure: Blood pressure decreased from severely elevated readings (162/112 mm Hg and 166/110 mm Hg) to 152/90 mm Hg, reflecting a partial response to antihypertensive therapy. Although still above normal, the downward trend indicates some improvement in maternal hemodynamic status.

• Edema: The client continues to have +3 pitting edema in bilateral lower extremities, which has not improved since the previous day. Persistent edema suggests that fluid balance and vascular permeability issues related to preeclampsia remain a concern and require ongoing monitoring.