A nurse is assisting with the care of a client who last used heroin 8 hr ago. Which of the following findings should the nurse identify as a manifestation of opioid withdrawal?

• Reviewing fetal heart rate tracing: Reviewing the fetal heart rate tracing is the first action because the client has signs of severe preeclampsia, which can quickly lead to fetal distress. The fetal monitor will provide immediate information about the baby’s oxygenation status. Detecting any late decelerations or bradycardia would require urgent intervention to protect fetal life.
• Administering IM betamethasone: Administering IM betamethasone is important to accelerate fetal lung maturity in case early delivery is necessary. Since the client is only at 31 weeks, promoting lung development is crucial to improve neonatal outcomes. However, confirming fetal well-being comes first before giving medications.
• Scheduling an emergency cesarean section: An emergency cesarean section is not the first step without evidence of fetal compromise or maternal instability. At this point, the fetal heart rate shows moderate variability and accelerations, which are reassuring. A cesarean is only scheduled if fetal distress or worsening maternal condition occurs after further monitoring.
• Insert a Foley catheter to monitor urine output: Inserting a Foley catheter is important to monitor kidney function and fluid status in preeclampsia. Reduced urine output can signal worsening disease. However, it is not the priority over assessing the fetal condition first, because fetal distress can occur rapidly and needs immediate identification.
• Administering antibiotics: There is no current indication for administering antibiotics based on the client's data. The client does not have signs of infection, such as fever, elevated WBCs, or positive urinalysis for infection. Administering antibiotics would not address the current primary risks related to severe preeclampsia.

A. Handling cat feces: Toxoplasmosis is most commonly transmitted through exposure to Toxoplasma gondii, a parasite found in cat feces. Handling contaminated litter, soil, or sand without proper hygiene can lead to infection, making this the correct response.

B. Drinking contaminated water: While contaminated water can transmit various infections, toxoplasmosis is primarily associated with exposure to cat feces or undercooked meat, not typically with drinking water.

C. Eating shellfish: Eating shellfish can expose individuals to other types of infections, such as hepatitis A or certain bacterial infections, but it is not a known source of toxoplasmosis.

D. Touching body fluids: Toxoplasmosis is not spread through casual contact with body fluids like saliva, blood, or urine. It is mainly transmitted through ingestion of the parasite from contaminated sources.