The nurse is continuing to assist with the care of the client. The nurse is assisting with initiating the client's plan of care. Which of the following interventions should the nurse include? Select all that apply.

Brief introduction: This clinical scenario describes a 31-week pregnant client presenting with severe hypertension, significant proteinuria, hyperreflexia, and edema, consistent with severe preeclampsia. Severe preeclampsia is a multisystem hypertensive disorder of pregnancy characterized by vasospasm, endothelial dysfunction, and end-organ involvement. It poses serious risks to both maternal and fetal well-being, including seizure (eclampsia), placental insufficiency, and preterm birth. Management focuses on stabilizing blood pressure, preventing seizures, monitoring organ function, and promoting fetal lung maturity. Rationale: A. Assisting with vaginal examinations every 12 hours is not appropriate in severe preeclampsia unless labor is confirmed and specifically indicated. Frequent vaginal exams increase the risk of infection and are not a priority in stabilization. In this condition, cervical assessment is minimized unless active labor or delivery planning is underway due to maternal instability. B. Monitoring intake and output hourly is essential because severe preeclampsia can impair renal perfusion, leading to oliguria and fluid retention. Strict monitoring helps detect early signs of renal compromise and fluid overload. It also guides safe fluid management and prevents complications such as pulmonary edema. C. Providing a low-stimulation environment is crucial to reduce the risk of seizure development (eclampsia). Decreasing noise, light, and external stimuli helps minimize central nervous system irritability associated with severe hypertension and hyperreflexia. This intervention supports neurological stability and patient safety. D. Obtaining a 24-hour urine specimen is important to quantify proteinuria and assess the severity of preeclampsia. The presence of 3+ protein on urinalysis already suggests significant renal involvement. This test provides a more accurate measurement of protein loss and helps guide ongoing management decisions. E. Maintaining bed rest helps reduce metabolic demands and improves uteroplacental perfusion in severe preeclampsia. It decreases physical stress and helps stabilize blood pressure while allowing close maternal and fetal monitoring. Left lateral positioning further enhances venous return and uterine blood flow. F. Giving antihypertensive medication is necessary to manage severe-range blood pressures (≥160/110 mm Hg) and reduce the risk of maternal complications such as stroke. Medications are used to maintain safer blood pressure levels while ensuring adequate placental perfusion. Prompt treatment is essential to prevent end-organ damage. G. Administering betamethasone is indicated at 31 weeks gestation to promote fetal lung maturity in anticipation of possible preterm delivery. Corticosteroids accelerate surfactant production, reducing the risk of neonatal respiratory distress syndrome. This intervention is standard in high-risk pregnancies where early delivery is likely.