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.

Rationale: A. Amniocentesis is not indicated in this situation. The client’s findings (hypertension, thrombocytopenia, elevated liver enzymes, proteinuria, hyperuricemia, and symptoms such as headache and RUQ pain) are consistent with severe preeclampsia with possible HELLP syndrome. Management focuses on maternal stabilization and possible delivery, not fetal lung maturity testing via amniocentesis. B. Preeclampsia and HELLP syndrome are not infectious conditions. Standard precautions are appropriate, but contact precautions are unnecessary. C. Internal fetal monitoring (e.g., fetal scalp electrode) requires ruptured membranes and sufficient cervical dilation, and it is typically avoided unless necessary. In a client with severe preeclampsia, the priority is maternal stabilization and noninvasive fetal monitoring unless labor is progressing. D. The client has worsening hypertension (156/96 mm Hg) consistent with severe preeclampsia. Frequent blood pressure monitoring is essential to assess progression and guide antihypertensive therapy. E. The client has severe preeclampsia with headache and hyperreflexia (3+ DTRs), indicating increased seizure risk. A quiet, low-stimulation environment helps reduce the risk of seizures. F. Bed rest (typically left lateral positioning) helps improve uteroplacental perfusion and reduce blood pressure in clients with preeclampsia. Although strict bed rest is less commonly prescribed long-term, in acute severe cases hospitalization with limited activity is appropriate. G. The client already has hyperreflexia (3+ DTRs), a warning sign of worsening CNS irritability and impending eclampsia. Ongoing monitoring is essential to detect progression. H. The client has elevated creatinine and BUN, indicating possible renal involvement. Monitoring urine output helps assess kidney perfusion and detect worsening preeclampsia or renal impairment.