A nurse in a family planning clinic is caring for a client who requests an oral contraceptive. Which of the following findings in the client's history should the nurse recognize as a contraindication to oral contraceptives? (Select all that apply)

The correct instruction is C. "Check the temperature of your baby's bath water with your hand."

Explanation:

A. "You can share your room with your baby for the next few weeks": This is a recommended practice. The American Academy of Pediatrics (AAP) recommends room-sharing without bed-sharing for at least the first six months and ideally for the first year of a baby's life. It promotes safe sleep and reduces the risk of Sudden Infant Death Syndrome (SIDS).

B. "Cover your baby with a light blanket while sleeping": This instruction is not recommended. The AAP advises against using loose bedding, including blankets, in the sleep environment to reduce the risk of SIDS. It is safer to use sleep sacks or wearable blankets if additional warmth is needed.

C. "Check the temperature of your baby's bath water with your hand": This is the correct instruction. It is essential to ensure that the bathwater is not too hot to prevent burns. Checking with the hand is a practical way to assess the water temperature before placing the baby in the bath.

D. "Your baby can nap in the car seat during the daytime": While napping in a car seat during travel is acceptable, it is not recommended for routine or prolonged sleep. The upright position in a car seat may compromise the baby's airway, increasing the risk of breathing difficulties. It's advised to transfer the baby to a flat, firm sleep surface for regular naps.

The correct answer is A. Blood pressure 80/56 mm Hg.

A. A blood pressure of 80/56 mm Hg is the priority finding. Opioid analgesia can cause hypotension, and addressing low blood pressure is crucial to prevent maternal and fetal complications. The nurse should notify the healthcare provider promptly and implement interventions to improve blood pressure.

B. Profuse itching is a common side effect of opioids and is generally not considered a priority unless it becomes severe or is accompanied by other concerning symptoms.

C. A temperature of 38.2°C (100.8°F) may indicate a fever, but addressing hypotension takes precedence. Elevated temperature can be further assessed but is not the priority in this scenario.

D. The client reporting weakness of the lower extremities is a concerning symptom, but the priority is to address hypotension first, as it could be related to opioid-induced hypotension.