A nurse working in labor and delivery is assisting in the care of a client who is at 30 weeks of gestation. Complete the following sentence by using the list of options. The client is at risk for developing dropdowndue todropdown.

Rationale for correct choices: • Placental abruption: The client exhibits sudden-onset hypertension, epigastric pain, headache, and facial edema at 30 weeks gestation, which are risk factors for placental abruption. Abruption involves premature separation of the placenta from the uterine wall, leading to maternal and fetal compromise. Early recognition is critical due to potential hemorrhage, fetal distress, and preterm delivery. • Hypertension: The client’s blood pressure readings (148/94 mm Hg and 156/96 mm Hg) are significantly elevated for gestation, indicating preeclampsia or gestational hypertension. Hypertension increases the risk for placental abruption by causing vascular injury and reduced placental perfusion. Rationale for incorrect choices: • Postpartum hemorrhage: Postpartum hemorrhage occurs after delivery and is not a risk during the antepartum period at 30 weeks. While abruption can lead to bleeding, postpartum hemorrhage specifically refers to hemorrhage after birth and is not directly indicated by current findings. • Placenta previa: Placenta previa involves implantation of the placenta over or near the cervical os, often presenting with painless vaginal bleeding. The client reports epigastric pain, headache, and hypertension, which are not characteristic of placenta previa. • Hyperreflexia: While hyperreflexia is noted (DTRs 3+ bilaterally) and may indicate preeclampsia, it is a clinical finding rather than a direct cause of placental abruption. It is an important assessment parameter but does not independently increase the risk of abruption. • Vomiting: Vomiting is a symptom the client reports but is not a primary risk factor for placental abruption. It may indicate associated preeclampsia or general discomfort but does not contribute directly to vascular placental separation.