A nurse is caring for a client who is pregnant.

The nurse is reviewing the client's medical record.
Select 4 findings that indicate a potential prenatal complication.

A. Conflict manager: A conflict manager helps parties resolve disagreements and mediate disputes. In this scenario, the nurse is not mediating between the client and their partner but is providing guidance directly to the client.

B. Advocate: Acting as a client advocate involves supporting the client’s rights, choices, and best interests, even when others may disagree. By providing information about treatment termination, the nurse empowers the client to make informed decisions independently.

C. Social worker: A social worker provides counseling, resources, and support for psychosocial needs. While the nurse may offer similar guidance, the role described focuses on protecting client rights rather than providing social services.

D. Negotiator: A negotiator facilitates agreement between parties through discussion or compromise. The nurse is not negotiating with the partner but is supporting the client’s autonomy, which aligns with advocacy rather than negotiation.

A. WBC count 22,000/mm³ (5,000 to 10,000/mm³): Leukocytosis is a common finding in appendicitis due to the inflammatory and infectious process. A significantly elevated WBC count supports the diagnosis and indicates the body’s response to infection.

B. Diarrhea: Diarrhea is not a typical manifestation of appendicitis. Clients more commonly present with constipation or localized abdominal pain rather than frequent loose stools, so this finding is not characteristic.

C. Rebound tenderness: Rebound tenderness, especially in the right lower quadrant, is a classic sign of peritoneal irritation associated with appendicitis. Pain that increases when pressure is released is a key physical examination finding.

D. Low-grade fever: A low-grade fever often accompanies appendicitis due to the body’s inflammatory response. Fever typically develops as the condition progresses and can help differentiate appendicitis from other causes of abdominal pain.

E. Hyperactive bowel sounds: Hyperactive bowel sounds are more commonly associated with gastroenteritis or early intestinal obstruction. In appendicitis, bowel sounds are often normal or decreased, particularly if peritoneal irritation is present.