A nurse is planning care for a client who is at 31 weeks of gestation and has preeclampsia with severe features. The client has a new prescription for magnesium sulfate via continuous IV infusion. Which of the following actions should the nurse plan to take?

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.

A. Administer a dose of fluoxetine to the client: Fluoxetine is an antidepressant and is not indicated for acute psychotic symptoms such as auditory hallucinations in schizophrenia. Antipsychotic medications, not SSRIs, are the standard treatment for managing hallucinations.

B. Avoid making eye contact with the client: Avoiding eye contact can be perceived as disengagement or disinterest, which may increase the client’s anxiety or mistrust. Therapeutic communication with appropriate eye contact helps establish rapport and conveys presence and support.

C. Request the client to lie down in a quiet room: Forcing the client to lie down may increase distress or feelings of loss of control. While a quiet environment can reduce stimuli, the intervention should be voluntary and focused on coping strategies rather than directives.

D. Encourage the client to listen to music: Listening to music can help distract the client from hallucinations and provide a coping mechanism to reduce distress. This intervention supports safety, comfort, and engagement without confrontation, aligning with therapeutic approaches for managing auditory hallucinations.