A nurse is caring for a client who is pregnant. The nurse is reviewing the client's medical record.

Exhibits

Select 4 findings that indicate a potential prenatal complication

Rationale:

A. Use a loud tone of voice when speaking with the client: Clients with visual impairments do not necessarily have hearing loss. Speaking loudly is unnecessary and may be perceived as disrespectful or startling. Clear, calm, and descriptive communication is more appropriate.

B. Rearrange client’s bedside table items frequently: Frequently moving personal items creates confusion and increases the risk of accidents or frustration for a visually impaired client. Consistent item placement enhances safety and independence.

C. Guide the client by walking parallel with them: Walking parallel without physical or verbal guidance may not be helpful. It’s more effective to offer the client your arm so they can follow your movement and safely navigate their surroundings.

D. Remove objects from client's path to the bathroom: Clearing obstacles from the client's walking path reduces the risk of tripping and falls. This is a key safety intervention for clients with reduced visual sensory perception and promotes independent, safe mobility.

Rationale:

A. A client who has decreased interleukin-6 levels: Interleukin-6 is a pro-inflammatory cytokine that may be elevated in depression, but its decrease is not an indicator for antidepressant use. It’s not routinely used to determine the need for antidepressant therapy in clinical practice.

B. A client who has decreased urine cortisol levels: Depression is more commonly associated with increased cortisol levels due to stress responses. Low cortisol may be seen in conditions like Addison's disease but does not typically guide antidepressant use.

C. A client who has decreased C-reactive protein levels: CRP is a nonspecific inflammatory marker. While elevated CRP has been observed in some individuals with depression, a decreased CRP level would not indicate the need for antidepressant therapy.

D. A client who has decreased serotonin levels: Low serotonin levels are closely linked to depression pathophysiology. Many antidepressants, such as SSRIs, target serotonin levels to relieve depressive symptoms, making this the most relevant indicator for antidepressant therapy.