A nurse is planning to discharge a postpartum client who is exclusively breastfeeding their newborn. Which of the following instructions should the nurse include?

A. Scaly plaques on skin: Scaly plaques are more characteristic of chronic conditions like psoriasis, not Stevens-Johnson syndrome. SJS is an acute, severe mucocutaneous reaction involving widespread epidermal necrosis, not thick, scaly lesions.

B. Pearly papules with a central crater: This describes basal cell carcinoma, a form of skin cancer. It is not consistent with the acute, inflammatory, and blistering nature of Stevens-Johnson syndrome, which typically involves mucous membranes and skin detachment.

C. Weeping skin surfaces: Stevens-Johnson syndrome leads to widespread skin blistering, sloughing, and erosion, often resulting in moist, weeping lesions. This breakdown of the epidermis resembles a severe burn and is a hallmark of the condition.

D. Irregularly shaped, pigmented papules: These are often associated with melanoma or other pigmented skin disorders. They do not match the blistering, painful rash and mucosal involvement seen in SJS.

• Opioid intoxication:The client shows hallmark signs of opioid overdose bradypnea, pinpoint pupils, hypothermia, confusion, and hypotension after a long history of oxycodone use and functional decline.
• Obtain prescription for naloxone:Naloxone is an opioid antagonist that rapidly reverses life-threatening respiratory depression caused by opioid toxicity and should be administered promptly.
• Prepare to initiate mechanical ventilation:Due to the client's shallow respirations and oxygen saturation of 90% on room air, assisted ventilation may be needed to maintain adequate oxygenation post-naloxone or if unresponsive.
• Respiratory rate:Hypoventilation is the most critical complication of opioid overdose; frequent monitoring is essential to detect deterioration or improvement following naloxone administration.
• Pupillary reaction:Constricted pupils are a key indicator of opioid toxicity. Monitoring for dilation after naloxone helps assess the reversal of opioid effects and neurologic improvement.