A nurse is caring for a client who is at 20 weeks of gestation Which of the following actions should the nurse plan to take? Select all that apply.

A. Apply internal fetal monitor: An internal fetal monitor is used to assess fetal heart rate and contractions in a viable pregnancy. In this case, the client has a molar pregnancy with no viable fetus, so fetal monitoring is not appropriate and provides no clinical benefit. B. Prepare client for dilation and curettage with suction: Suction dilation and curettage (D&C) is the primary treatment for a molar pregnancy to remove abnormal trophoblastic tissue. Planning for this procedure is essential to prevent complications such as hemorrhage, persistent gestational trophoblastic disease, and infection. C. Administer 1 hr glucose tolerance test: Glucose screening is not indicated at this time. The client is only 20 weeks gestation and is being managed for a molar pregnancy, not for routine prenatal care or gestational diabetes screening. This test is not a priority. D. Refer client to perinatal loss support group: A molar pregnancy is considered a pregnancy loss, and the client may experience emotional distress. Referral to a perinatal loss support group provides psychological support and helps the client cope with grief and anxiety associated with this event. E. Provide the client with instructions on medroxyprogesterone therapy: Medroxyprogesterone therapy is not indicated for managing a molar pregnancy. Contraception may be discussed after treatment, but this is not an immediate priority during acute management of the condition. F. Administer Rho(D) immune globulin: The client is Rh-negative, and any procedure that may cause fetomaternal hemorrhage, such as D&C, requires administration of Rho(D) immune globulin to prevent isoimmunization in future pregnancies. This is a critical prophylactic intervention in Rh-negative clients.