A nurse is providing discharge teaching to a client who has chronic kidney disease and is receiving hemodialysis. Which of the following Instructions should the nurse include in the teaching?

Conditions:

1. Placental abruption, the premature separation of the placenta from the uterine wall, can occur due to hypertension, which increases the risk of vascular damage and bleeding behind the placenta, leading to its separation.
2. Oligohydramnios, a condition characterized by a deficiency of amniotic fluid, is typically associated with decreased fetal urine production, renal abnormalities, or placental insufficiency. However, none of the findings listed in the scenario directly correlate with this condition.
3. Spontaneous abortion, also known as miscarriage, can occur due to various factors such as genetic abnormalities, hormonal imbalances, or maternal health conditions. However, none of the findings listed in the scenario directly correlate with this condition.
4. Chorioamnionitis is an infection of the fetal membranes and amniotic fluid. While maternal fever is often associated with chorioamnionitis, it is not a finding listed in the scenario. Additionally, the other findings do not directly correlate with this condition.
5. Placenta previa is a condition where the placenta partially or completely covers the cervix. This condition is not directly associated with the findings listed in the scenario.

Findings:

1. Hypertension is a risk factor for placental abruption due to increased vascular resistance, which can lead to vascular damage and placental separation.
2. Temperature elevation may indicate an infection, such as chorioamnionitis, which can increase the risk of placental abruption.
3. Hyperreflexia can be associated with conditions like preeclampsia, which is characterized by hypertension and can increase the risk of placental abruption.
4. Vomiting alone is not directly associated with an increased risk of placental abruption.
5. Fundal height measurement can provide information about fetal growth and gestational age but is not directly associated with an increased risk of placental abruption.

A. Sinus arrhythmia is a benign condition that does not typically require immediate assessment unless accompanied by other concerning symptoms.
B. Tachypnea in a client with a hip fracture may indicate a potential complication such as pulmonary embolism or respiratory compromise, requiring immediate assessment and intervention.
C. While weakness in the lower extremities in a client with epidural analgesia warrants assessment, it is not as urgent as assessing a client with new-onset tachypnea.
D. An HbA1c level of 7.2% in a client with diabetes mellitus, while slightly above the target range, does not require immediate assessment or intervention unless accompanied by acute symptoms of hyperglycemia.