A nurse is assessing the newborn of a client who took a selective serotonin reuptake inhibitor (SSRI) during pregnancy. Which of the following manifestations should the nurse identify as an indication of withdrawal from an SSRI?

Choice A Reason:

"You can miss your period for several other reasons. Describe your typical menstrual cycle." This response acknowledges that a missed period can result from various factors other than pregnancy, such as stress, changes in weight, hormonal fluctuations, or certain medical conditions. Understanding the client's typical menstrual cycle can help the nurse gather more information about potential reasons for the late period.

Choice B Reason:

"If you have been sexually active and haven't used protection, it is likely that you are pregnant. “This response assumes pregnancy without exploring other possibilities or the client's individual situation.

Choice C Reason:

"Let's check to see if you have any other signs of pregnancy. Have you noticed any abdominal enlargement yet?" While considering other signs of pregnancy is reasonable, focusing on abdominal enlargement may not be the most accurate early indicator, and it's essential to explore a broader range of symptoms.

Choice D Reason:

"Because you have missed your period, you should try taking a home pregnancy test before you start worrying. "While suggesting a home pregnancy test is reasonable, it may be more beneficial to gather additional information about the client's menstrual cycle and potential symptoms before jumping directly to a test.

The correct answer is D. "There are so many variables that you'll have to ask your obstetrician."

A. "It's too soon for you to be worrying about this now" dismisses the client's concerns and does not provide useful information. It's important to address the client's question and offer guidance.

B. "A repeat cesarean birth is safer for both you and your baby" may not be accurate for all situations. The decision on the mode of delivery (vaginal birth after cesarean - VBAC or repeat cesarean) depends on various factors, and a blanket statement may not apply.

C. "The primary consideration is what type of incision was performed this time" is partially correct.

The type of uterine incision in the current cesarean birth is one factor to consider, but it is not the only consideration. Other factors, such as the reason for the previous cesarean, maternal health, and the obstetrician's assessment, also play a role.

D. "There are so many variables that you'll have to ask your obstetrician" is the most appropriate response.

The decision regarding the mode of delivery in subsequent pregnancies after a cesarean is individualized and depends on various factors. The obstetrician will consider the woman's health, the reason for the previous cesarean, the type of uterine incision, and other relevant factors to provide personalized guidance.