A nurse is assessing a client who has a calcium deficiency. The nurse should identify that the client is at risk for which of the following conditions?

A. Shakiness: Shakiness is typically a manifestation of hypoglycemia, resulting from activation of the sympathetic nervous system. It occurs when blood glucose drops below normal levels, not with hyperglycemia, so it is not associated with a glucose level of 265 mg/dL.

B. Confusion: Confusion can occur with both severe hyperglycemia and hypoglycemia, but it is more pronounced in extreme elevations of blood glucose or in hyperosmolar hyperglycemic states. A level of 265 mg/dL may not yet cause marked cognitive changes in all clients.

C. Thirst: Hyperglycemia causes osmotic diuresis, leading to fluid loss and dehydration, which triggers excessive thirst (polydipsia). This is a common and early clinical manifestation associated with elevated blood glucose levels such as 265 mg/dL.

D. Diaphoresis: Diaphoresis, or excessive sweating, is primarily a symptom of hypoglycemia caused by adrenergic stimulation. It is not a typical manifestation of hyperglycemia and is unlikely to occur with a blood glucose of 265 mg/dL.

A. Group B streptococcus β-hemolytic status: The client is GBS negative, which does not indicate a labor complication. This finding decreases the need for intrapartum antibiotic prophylaxis and does not pose a risk to the fetus or labor progress at this time.

B. Maternal heart rate: The maternal heart rate is 110/min, which is elevated and may indicate early systemic infection, especially when paired with fever. Tachycardia during labor can signal maternal distress or infection and requires prompt assessment to prevent maternal and fetal complications.

C. Contraction pattern: Contractions are occurring every 5 minutes for the past hour but are not described as coordinated or progressing normally. In the presence of infection markers such as fever and tachycardia, this pattern may suggest dysfunctional labor, where infection or inflammation disrupts normal uterine activity.

D. Vaginal discharge: The discharge is described as malodorous and nitrazine-positive, findings that strongly suggest possible chorioamnionitis or another infectious process. Odorous fluid associated with ruptured membranes requires immediate provider notification due to risks of neonatal sepsis.

E. Cervical assessment: The client is now 3 cm dilated, which is appropriate for early labor in a primigravida and does not indicate a complication. This finding aligns with expected cervical changes leading toward active labor.

F. Pain rating: A pain score of 4 at rest and 8 during contractions is typical for early labor and does not represent a complication. Pain naturally increases as contractions strengthen and the cervix dilates, reflecting normal physiologic progression.

G. Temperature: A temperature of 38.7°C (101.7°F) indicates maternal fever, a significant concern during labor. Fever in combination with tachycardia and abnormal discharge suggests intra-amniotic infection, which can rapidly progress and threaten both maternal and fetal well-being.