A nurse is reinforcing teaching about preterm labor with a client who is at 28 weeks of gestation. Which of the following statements by the client indicates an understanding of the teaching?

(a) "White blood cell count is an indicator of anemia."
A white blood cell (WBC) count is primarily used to assess for infection or inflammation, not anemia. Anemia is typically evaluated by measuring hemoglobin and hematocrit levels, not WBC count. This statement indicates a misunderstanding of the purpose of the WBC count.

(b) "Urine specific gravity identifies my risk for pregnancy induced hypertension."
Urine specific gravity measures the concentration of urine and is used to assess hydration status and kidney function. It does not directly identify the risk for pregnancy-induced hypertension (PIH). The presence of protein in the urine (proteinuria) would be more indicative of PIH. This statement indicates a misunderstanding of the purpose of the urine specific gravity test.

(c) "Platelet count identifies if I am at risk for bleeding."
This is the correct statement. A platelet count is used to determine the number of platelets in the blood, which are essential for normal blood clotting. A low platelet count (thrombocytopenia) can indicate an increased risk of bleeding, while a high count (thrombocytosis) can be associated with clotting disorders.

(d) "Sedimentation rate checks for signs of cancer."
The erythrocyte sedimentation rate (ESR) measures how quickly red blood cells settle at the bottom of a test tube. It is a nonspecific test used to detect inflammation in the body. While an elevated ESR can be associated with various conditions, including infections, autoimmune diseases, and cancers, it is not specifically used to check for cancer. This statement indicates a misunderstanding of the purpose of the sedimentation rate test.

(A) Diuresis:
Diuresis, or increased urine production, is not a typical adverse effect of nalbuphine hydrochloride. Opioids generally do not affect urine output in the same way as diuretic medications.

(B) Fever:
Fever is not a common adverse effect of nalbuphine hydrochloride. If a client develops a fever during labor, it could indicate other underlying causes such as infection or inflammation, but it is not directly related to the administration of this medication.

(C) Diarrhea:
Diarrhea is not a typical adverse effect of nalbuphine hydrochloride. Opioid medications are more commonly associated with constipation due to their effects on gastrointestinal motility and function.

(D) Sedation:
Nalbuphine hydrochloride is an opioid analgesic used for pain relief during labor. Sedation is a common adverse effect of opioid medications, including nalbuphine. Opioids can depress the central nervous system, leading to drowsiness, sedation, and decreased level of consciousness. It's essential for the nurse to monitor the client closely for signs of sedation, especially during labor, to ensure the safety of both the mother and the baby.