A pregnant client at 28 weeks gestation is admitted with severe preeclampsia and develops disseminated intravascular coagulation (DIC). Which nursing action should be the highest priority?

Scenario: A 28-week pregnant client with severe preeclampsia develops DIC. Prioritize care using the ABC framework.

ABC Assessment:

• Airway: Ensure patency; DIC can cause oropharyngeal bleeding or edema.
• Breathing: Assess lung sounds, SpO2, and work of breathing. Pulmonary edema or ARDS can develop.
• Circulation: Monitor BP, HR, capillary refill, and LOC. Tachycardia and hypotension indicate hypovolemic shock from hemorrhage.

Key Management Steps:

1. Stabilize ABCs: Establish IV access, administer oxygen, and prepare for fluid resuscitation with crystalloids.
2. Notify Provider: Immediately communicate deterioration and need for urgent labs (CBC, coagulation panel, fibrinogen).
3. Administer Blood Products: Once stabilized, transfuse FFP, cryoprecipitate, or platelets as ordered to correct coagulopathy.
4. Maternal-Fetal Monitoring: Continuous electronic fetal monitoring and maternal vital signs to assess for fetal distress and guide delivery timing.

Rationale: DIC is a life-threatening emergency where clotting and bleeding occur simultaneously. The immediate threat to life is hemodynamic collapse from hemorrhage, making circulatory support the highest priority over replacing factors or definitive delivery.