A nurse is reinforcing teaching with a client who has a neurogenic bladder and a prescription for intermittent urinary self-catheterizations. Which of the following statements by the client shows an understanding of the teaching?

Postoperative clients are at increased risk for infection due to surgical incisions, invasive devices, and tissue trauma that can disrupt normal barriers to pathogens. Early recognition of infection is critical to prevent complications such as wound dehiscence, sepsis, and delayed healing. Laboratory and clinical indicators help nurses identify infection in its early stages. One of the most reliable early markers is an elevated white blood cell count, which reflects immune system activation.

Rationale:
A. Elevated WBC count is a common laboratory finding in infection because the body responds to pathogens by increasing leukocyte production. This leukocytosis indicates activation of the immune system as it attempts to fight invading microorganisms. In a postoperative client, an increasing WBC count beyond normal limits is an important early sign of possible infection.

B. A temperature of 37.2°C (99.0°F) is within the normal or slightly elevated range and does not indicate infection. Mild temperature variations can occur postoperatively due to inflammation or atelectasis but are not diagnostic of infection. Clinically significant infection typically presents with a higher and persistent fever.

C. Increased urinary output is not associated with infection in a postoperative client. Infection is more commonly linked to changes such as fever, leukocytosis, or localized signs at the surgical site. Urinary output is more reflective of hydration status, renal function, or fluid management rather than infection.

D. A pain rating of 4 on a 0–10 scale is expected in the postoperative period and is not specific to infection. Post-surgical pain is common due to tissue trauma and healing processes. Although worsening or disproportionate pain may warrant further evaluation, a moderate pain score alone is not an indicator of infection.

Pregnancy complications such as hypertensive disorders require prompt recognition because they can rapidly progress to conditions like preeclampsia and threaten both maternal and fetal well-being. Key warning signs include severe hypertension, proteinuria, neurological symptoms, and decreased fetal movement, which may indicate uteroplacental insufficiency. These findings reflect end-organ involvement and impaired placental perfusion. Early identification allows timely intervention to prevent severe maternal and fetal outcomes.

Rationale:

A. Decreased fetal activity is a significant concern in pregnancy as it may indicate reduced uteroplacental perfusion and fetal hypoxia. In hypertensive disorders, placental blood flow can be compromised, leading to decreased fetal movement. This requires immediate follow-up because it may signal fetal distress.

B. Urine protein of 3+ indicates significant proteinuria, which is a key diagnostic feature of preeclampsia. This reflects endothelial damage and increased glomerular permeability associated with hypertensive disorders of pregnancy. It is a critical finding requiring urgent evaluation and monitoring.

C. Severe headache unrelieved by acetaminophen is a concerning neurological symptom associated with severe preeclampsia. It suggests cerebral vasospasm or increased intracranial pressure. This requires immediate follow-up because it may precede complications such as eclampsia or stroke.

D. Gravida 3 para 2 indicates obstetric history but does not represent an acute clinical complication in the current pregnancy. It provides background risk information, but it does not reflect a current abnormal finding requiring urgent intervention.

E. Blood pressure of 162/112 mm Hg is severely elevated and consistent with hypertensive disorder of pregnancy. This level significantly increases risk for maternal complications such as stroke, placental abruption, and organ dysfunction. It requires immediate intervention and close monitoring.

F. Respiratory rate of 16/min is within normal limits and does not indicate respiratory compromise. There is no evidence of distress or abnormal respiratory pattern in this finding. It is not related to the suspected prenatal complication.

G. Urine ketones are negative, indicating no significant fat metabolism or starvation state. This is a normal finding and does not suggest a pregnancy-related complication. Therefore, it does not require follow-up.