A nurse is conducting health promotion education regarding contraindications to combination oral contraceptive use to a group of women. Which of the following conditions should the nurse include in the teaching?

Hypercapnia (elevated PaCO2)

Malignant hyperthermia: Yes. Malignant hyperthermia (MH) is a life-threatening condition triggered by certain anesthetic agents, and it leads to hypermetabolism, muscle rigidity, and hypercapnia (elevated carbon dioxide levels.
Latex allergy: No. Hypercapnia is not associated with latex allergy.
Hypovolemic shock: Yes. In hypovolemic shock, hypercapnia can occur as a compensatory response due to tissue hypoxia and poor perfusion. However, it is less directly characteristic of hypovolemic shock than of malignant hyperthermia.
2. Wheezes
Malignant hyperthermia: No. Wheezing is not a typical feature of malignant hyperthermia. Instead, it is primarily characterized by muscle rigidity, hypercapnia, and tachycardia.
Latex allergy: Yes. A latex allergy can cause respiratory symptoms, including wheezing, shortness of breath, or bronchospasm. This can occur when an allergic reaction triggers an asthma-like response in the airways.
Hypovolemic shock: No. Wheezing is not characteristic of hypovolemic shock. Hypovolemic shock primarily involves signs of decreased blood volume and perfusion, such as tachycardia, hypotension, and altered mental status.
3. Urticaria (hives)

Malignant hyperthermia: No. Urticaria is not a feature of malignant hyperthermia. MH is characterized by hyperthermia, muscle rigidity, and tachycardia, not an allergic skin reaction.
Latex allergy: Yes. Urticaria (hives) is a common sign of a latex allergy. An allergic reaction to latex can lead to skin reactions, including hives, itching, or rash.

Hypovolemic shock: No. Urticaria is not a typical finding in hypovolemic shock. In hypovolemic shock, the primary concern is hypotension, tachycardia, cool, clammy skin, and poor perfusion, not skin reactions like hives.
4. Tachycardia

Malignant hyperthermia: Yes. Tachycardia is a prominent feature of malignant hyperthermia, often occurring alongside hyperthermia (high body temperature) and muscle rigidity. The elevated heart rate is a response to the increased metabolic demand and stress during MH.
Latex allergy: Yes. Tachycardia can be a response to an allergic reaction such as latex allergy. In more severe cases, anaphylaxis due to latex exposure can cause a rapid heart rate as part of the body's response to the allergic reaction.
Hypovolemic shock: Yes. Tachycardia is a compensatory mechanism in hypovolemic shock. As the body tries to compensate for fluid loss or reduced blood volume, the heart rate increases to maintain perfusion.
5. Muscle rigidity
Malignant hyperthermia: Yes. Muscle rigidity is a classic sign of malignant hyperthermia. It occurs as a result of abnormal muscle contraction, leading to increased metabolic activity, hyperthermia, and hypercapnia.
Latex allergy: No. Muscle rigidity is not a typical feature of latex allergy.
Hypovolemic shock: No. Muscle rigidity is not characteristic of hypovolemic shock, which is primarily marked by reduced blood volume, hypotension, and poor perfusion.

Client rates lower back pain as 0 on a scale from 0 to 10:

On Day 1, the client reported lower back pain, which could be associated with uterine contractions or other complications. By Day 2, the pain has resolved completely, with the client reporting a pain level of 0/10. This is a clear sign of improvement in her condition, especially since pain is often a key indicator of progress in antepartum care.

No reports of vaginal discharge:

On Day 1, the client reported pinkish vaginal discharge, which can be indicative of preterm labor or other complications. By Day 2, the absence of vaginal discharge suggests that the situation has improved, and the risk of preterm labor may be decreasing.

No uterine contractions noted:

On Day 1, the client had uterine contractions occurring every 8 minutes, which could be indicative of early labor or preterm labor. By Day 2, the absence of uterine contractions is a positive sign that the client is no longer experiencing early labor signs. This indicates that the situation is improving.

No further reports of burning with urination:

On Day 1, the client reported burning with urination, which was indicative of a urinary tract infection (UTI). On Day 2, the client no longer reports this symptom, suggesting that the urinary symptoms have resolved, and the infection may be improving, especially in light of ongoing treatment (e.g., antibiotics).

Laboratory Results Indicating Improvement:

WBC count 12,000/mm³ (Day 2) vs. 16,000/mm³ (Day 1):

The WBC count has decreased from 16,000/mm³ on Day 1 (which indicated infection or inflammation) to 12,000/mm³ on Day 2. Although the WBC count is still slightly elevated above the normal range (5,000-10,000/mm³), the decrease in WBC count suggests that the client's body is responding to treatment, and the infection or inflammation may be resolving.

Vital Signs Indicating Improvement:

Temperature 37.1° C (98.7°F) (Day 2) vs. 38.4° C (101.1°F) (Day 1):

The client’s fever has resolved, with a temperature decrease from 38.4°C (101.1°F) on Day 1 to 37.1°C (98.7°F) on Day 2. Fever is a common sign of infection, and the reduction in temperature suggests that the infection (likely a urinary tract infection) is being controlled and is improving.