The nurse in an antepartum clinic is caring for the client w…

The nurse in an antepartum clinic is caring for the client who is pregnant. Time Vital Signs Nurses Notes Medical History 0800: Temperature 36.6° C  (97.9° F) Heart rate 85/min Respiratory rate 20/min Blood pressure 180/99 mmHg       The client reports, “I have had a headache for 2 days. Tylenol does not relieve it. I have blurred vision and dizziness.” The client reports swelling in their feet. 2+ pitting edema of the lower extremities noted bilaterally Deep tendon reflexes 3+, absent clonus Fetal heart tones (FHT) 150/min  Gravida 4 Para 3 33 weeks of gestation Allergies: Sulfa Height 165 cm (66 in) Weight 82 kg (180 lb) BMI 30.6 3.2 kg (7 lb) weight gain over the last 2 weeks 0815: Heart rate 88 beats/min Respiratory rate 16 breaths/min Blood pressure 178/106 mm Hg     0830: Heart rate 84 beats/min Respiratory rate 18/min Blood pressure 174/105 mm Hg     Which assessment findings will the nurse report to the provider immediately? Select all that apply

The 39-week gestation client is admitted to the birthing uni…

The 39-week gestation client is admitted to the birthing unit reporting spontaneous rupture of membranes (SROM) occurring 25 hours ago. The amniotic fluid is clear, and the fetal heart rate is 120 beats/min with moderate variability. Which assessment is most important for the nurse to perform at this time?