A nurse is providing teaching to a client who has a new diagnosis of fibromyalgia. Which of the following client statements indicates an understanding of the teaching?

Choice A rationale:
The length of time the mother has been caring for the baby is not directly relevant to the risk of HIV transmission through breastfeeding. While a longer duration of breastfeeding may increase overall exposure, the primary concern is whether breastfeeding is occurring at all, as it presents a significant transmission route.

Choice B rationale:
Kissing does not typically transmit HIV, as the virus does not survive well outside the body. While there is a very low theoretical risk of transmission if both individuals have open sores or bleeding gums, it's not a primary concern in this scenario.

Choice C rationale:
The timing of the baby's last antibiotic treatment is not directly relevant to the risk of HIV transmission from breastfeeding. Antibiotics do not prevent or treat HIV infection, and their use would not impact the assessment of breastfeeding-related risks.

Choice D rationale:
Breastfeeding is a significant route of HIV transmission from mother to child. If the baby is breastfeeding, it's crucial for the nurse to determine the mother's viral load and CD4 count, assess the baby's HIV status, and provide appropriate counseling and interventions to reduce the risk of transmission. This information is essential for guiding decisions about infant feeding and potential prophylactic measures to protect the baby's health.

Choice A rationale:
Serum creatinine is a waste product that is produced by muscle metabolism and is normally excreted by the kidneys.
When kidney function is impaired, creatinine levels in the blood increase, making it a sensitive and specific indicator of renal function.
It is considered one of the most reliable markers for assessing kidney function and is routinely used to screen for and monitor kidney disease.

Choice B rationale:
Serum sodium is an electrolyte that is regulated by the kidneys, but it is not a direct measure of renal function. Sodium levels can be affected by various factors, including fluid intake, medications, and hormonal imbalances.
While abnormal sodium levels can sometimes be a sign of kidney dysfunction, they can also occur due to other conditions, making it less specific as an indicator of renal function.
Choice C rationale:

Blood urea nitrogen (BUN) is another waste product that is produced by the breakdown of proteins and is normally excreted by the kidneys.
However, BUN levels can be influenced by factors other than kidney function, such as dietary protein intake, dehydration, and gastrointestinal bleeding.
This makes BUN less specific than serum creatinine as a marker of renal function.

Choice D rationale:
Urine-specific gravity measures the concentration of solutes in urine, which can provide some information about kidney function.
However, it is not as sensitive or specific as serum creatinine.
Urine-specific gravity can be affected by factors such as fluid intake and hydration status, which can make it less reliable as an indicator of renal function.