A client who has a diagnosis of complete placenta previa is admitted to the labor and
delivery suite at 36 weeks gestation with contractions 5 minutes in frequency and 1 minute in duration. Which of the following actions should the nurse take?

A. Arterial blood gases - Arterial blood gases are not typically assessed before initiating lithium carbonate therapy.

B. Total cholesterol - Total cholesterol levels are not specifically relevant to monitoring lithium therapy.

C. Thyroid hormones - Thyroid function should be assessed before initiating lithium therapy because lithium can affect thyroid function, potentially leading to hypothyroidism.

D. Hemoglobin - While hemoglobin levels may be monitored during lithium therapy, they are not typically assessed prior to initiating treatment.

A. This response may come across as confrontational and could potentially shut down further communication. It's important to offer support and empathy rather than immediately probing with questions.

B. While saying, "You can trust me and tell me what you are thinking," may foster trust, it is too vague and does not focus on assessing the client’s level of suicidal ideation or intent. Effective responses should prioritize safety by exploring specific details about the client’s thoughts.

C. "I need to know what you mean by misery" focuses on understanding the client’s emotional state but does not address the immediate concern of suicidal thoughts. While exploring the client’s feelings is important, it is secondary to assessing imminent risk.

D. Asking, "Do you have a plan to end your life?" is appropriate because it directly assesses the client’s risk for suicide. Determining whether the client has a specific plan, the means to carry it out, and intent to act is essential for evaluating the severity of the situation and implementing safety measures.