A nurse is providing prenatal education to a 28-week primigravida at a community health clinic. The nurse teaches the patient which symptoms require immediate notification of the provider or a visit to the emergency department. Which symptoms should the nurse include as obstetric warning signs? Select all that apply.

After 28 weeks, decreased or absent fetal movement requires prompt evaluation (Choice 1). Vaginal bleeding at any stage of pregnancy is abnormal and needs assessment (Choice 2). Regular painful contractions before 37 weeks may indicate preterm labor (Choice 3). A severe persistent headache with visual changes can signal preeclampsia (Choice 4). Sudden marked swelling of the face and hands is also a preeclampsia warning sign (Choice 6). Mild morning nausea and vomiting during the first trimester is common and is not an emergency unless it becomes severe, causes dehydration or weight loss, or is accompanied by other concerning findings (Choice 5).