Question

The nurse in the prenatal clinic assesses a client at 31 weeks gestation. The client's blood pressure is 150/96, serum albumin level is 3 g/dl, 3+ protein is found in the urine, and the client's face and hands are edematous. Which instruction by the nurse is most important?

a) Increase your intake of salty foods to reduce edema.
b) Rest on your left side to promote better blood circulation.
c) Limit your fluid intake to decrease blood pressure.
d) Engage in strenuous physical activity to reduce swelling.

Answer 1

The nurse should instruct the client to rest on their left side to promote better blood circulation, which is crucial for managing high blood pressure and edema during pregnancy. This approach helps improve kidney function and blood flow, which can reduce blood pressure and alleviate edema.

Step-by-step explanation:

The student's question regarding the most important instruction to a client at 31 weeks gestation with high blood pressure, low serum albumin, protein in the urine, and edema relates to managing symptoms likely associated with a condition such as preeclampsia. The nurse should prioritize interventions aimed at stabilizing the client's condition and mitigating risks. The most advisable instruction from the options given would be:

Resting on the left side can help improve kidney function and blood flow, which can consequently reduce blood pressure and help alleviate edema. This is compared to other options like increasing salty foods, which can worsen edema, limiting fluids, which could result in dehydration and decreased plasma volume, or engaging in strenuous activity, which could elevate blood pressure and stress the cardiovascular system.

It's important to understand that therapy for edema involves addressing its underlying causes, which can vary from simple factors like prolonged standing to serious medical conditions. The relation between albumin deficiency and edema is also crucial, as albumin helps maintain oncotic pressure, preventing excessive fluid from leaking into tissue spaces. Recommended management may include appropriate exercises, elevation of affected parts, compression, massage, and decreased salt intake.