The nurse continues to care for the client who is at 30 weeks of gestation. Click to specify which of the following actions the nurse should anticipate including in the client's plan of care. Select all that apply.

A. Assess DTR: Hyperreflexia (3+ DTRs) is an early neurological sign of preeclampsia and potential progression to eclampsia. Monitoring deep tendon reflexes helps detect worsening central nervous system irritability and guides timely intervention. B. Encourage bed rest: Bed rest can reduce maternal blood pressure and improve uteroplacental perfusion in clients with preeclampsia. While strict bed rest is debated, modified rest in a low-stimulation environment is appropriate for symptom management and safety. C. Prepare for amniocentesis: Amniocentesis is not indicated in this scenario. The client’s presentation suggests preeclampsia with severe features, and amniocentesis does not address maternal hypertension, organ dysfunction, or fetal compromise. D. Monitor blood pressure: Frequent blood pressure monitoring is essential for detecting rapid increases or hypertensive crises in preeclampsia. Early detection allows prompt administration of antihypertensives and prevents complications such as stroke or placental abruption. E. Check urinary output: Oliguria can indicate worsening renal involvement in preeclampsia. Monitoring urinary output is crucial to assess renal function, fluid balance, and the severity of proteinuria. F. Initiate contact precautions: Preeclampsia is not an infectious condition; contact precautions are unnecessary. Standard precautions are sufficient unless another infectious risk is present. G. Apply internal fetal monitor: Internal fetal monitoring is invasive and only indicated when external monitoring is inadequate or continuous detailed monitoring is needed. Currently, fetal heart rate is being assessed externally and is stable. H. Decrease lighting in the client's room: Reducing environmental stimuli can help minimize neurological irritability and agitation in clients with severe preeclampsia, lowering the risk of seizures and promoting maternal comfort.