A nurse is assessing self-management skills for a client who has preeclampsia without severe features. Which of the following client statements should the nurse recognize as an indication the client is coping effectively?

Rationale:
A. Temperature 37.9° C (100.2° F): A mild temperature elevation is common in sickle cell crises due to inflammation or infection, but it does not independently indicate acute chest syndrome. It should be monitored but does not require immediate reporting unless it progresses or is accompanied by respiratory distress.

B. Sneezing: Sneezing is a nonspecific symptom often related to upper respiratory irritation or allergies. It does not signify acute chest syndrome or lower airway involvement and is not an immediate concern in this context.

C. Hematuria: Blood in the urine can occur from sickling in the renal vasculature but is not related to acute chest syndrome. While it requires evaluation, it does not pose an immediate respiratory threat.

D. Substernal retractions: Substernal retractions indicate increased work of breathing and respiratory distress, which are hallmark signs of acute chest syndrome. This complication involves pulmonary infarction or infection leading to hypoxia, and prompt provider notification is essential to prevent respiratory failure.

Rationale:
A. A client who has decreased urine cortisol levels: Hypercortisolism or dysregulated cortisol is more commonly linked to depressive symptoms, so decreased levels would not indicate a primary need for antidepressant therapy.

B. A client who has decreased interleukin-6 levels: Interleukin-6 is an inflammatory marker, and elevated levels have been associated with depression. Decreased IL-6 does not indicate inflammation-related depression or a need for antidepressants.

C. A client who has decreased C-reactive protein levels: Low C-reactive protein indicates minimal systemic inflammation. Since elevated CRP can correlate with depressive states, decreased CRP does not identify a candidate for antidepressant therapy.

D. A client who has decreased serotonin levels: Reduced serotonin is linked to depressive disorders. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), aim to increase serotonin availability in the brain, making this client an appropriate candidate for therapy.