A nurse is providing discharge instructions to a client who is breastfeeding her newborn. Which of the following instructions should the nurse include?

The correct answer is **Choice C: A client who has salicylate intoxication.**

Choice A rationale:

A client taking a thiazide diuretic is at risk for metabolic alkalosis, not metabolic acidosis. Thiazide diuretics can cause a loss of potassium and chloride, leading to a relative increase in bicarbonate and a higher pH, resulting in metabolic alkalosis.

Choice B rationale:

A client who is vomiting is at risk for metabolic alkalosis, not metabolic acidosis. Vomiting leads to a loss of gastric acid (hydrochloric acid), resulting in a relative increase in bicarbonate and a higher pH, leading to metabolic alkalosis.

Choice C rationale:

A client with salicylate intoxication is at risk for metabolic acidosis. Salicylates, the active ingredient in aspirin, can cause an increased production of organic acids, leading to a decrease in pH and the development of metabolic acidosis.

Choice D rationale:

A client with hypoventilation is at risk for respiratory acidosis, not metabolic acidosis. Hypoventilation leads to a buildup of carbon dioxide, which dissolves in the blood to form carbonic acid, resulting in a decrease in pH and respiratory acidosis.

Choice A rationale:

The Moro reflex, also known as the startle reflex, is elicited by making a loud noise above the newborn, causing them to extend their arms and legs and then bringing them back to the body in a hugging motion. This reflex is a normal developmental response in term newborns.

Choice B rationale:
Touching the newborn's cheek with a finger elicits the rooting reflex, where the newborn turns their head toward the stimulus, searching for a nipple or object to suck. It is a different reflex and not the Moro reflex.

Choice C rationale:
Tapping the newborn's forehead with a finger does not elicit any specific reflex. This action is not related to the Moro reflex.

Choice D rationale:
Turning the newborn's head to one side elicits the asymmetric tonic neck reflex (ATNR), not the Moro reflex. In ATNR, when the head is turned to one side, the arm on that side extends while the opposite arm flexes.