High School

A client's 32-week clinic assessment was:

- BP: 90/60
- TPR: 98.6°F, P: 92, R: 20
- Weight: 145 lb
- Urine: Negative for protein

Which of the following findings at the 34-week appointment should the nurse highlight for the certified nurse midwife?

A) BP: 110/70; TPR: 99.2°F, P: 88, R: 20
B) Weight: 155 lb; Urine protein: +2
C) Urine protein: Trace; BP: 88/56
D) Weight: 147 lb; TPR: 99.0°F, P: 76, R: 18

Answer :

Final answer:

The most concerning change from the 32-week to the 34-week appointment is weight gain of 10 lb and the presence of protein in urine, both of which should be highlighted to the nurse midwife.

Explanation:

The nurse should highlight option b) Weight 155 lb; urine protein +2 at the 34-week appointment for the nurse midwife. This is because an increase in weight of 10 lb in two weeks suggests excessive weight gain which could be a sign of gestational edema. Also, the presence of protein in the urine (+2) is significant as it might suggest potential kidney problems or preeclampsia, a serious condition in pregnancy characterized by high blood pressure and protein in the urine.

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