A nurse is providing teaching about self-care to a primigravid client who is at 9 weeks of gestation. Which of the following statements should the nurse include?

• Panic disorder: Typically presents with intense fear, chest pain, shortness of breath, dizziness, and a sense of doom. It is episodic, not sustained like mania, and does not include symptoms like euphoria, grandiosity, or hallucinations.
• Catatonia: Involves motor immobility, stupor, rigidity, or excessive purposeless movement. While this client is very active, their activity is goal-directed but disorganized, consistent with mania, not catatonia.
• Mania: Characterized by euphoric or irritable mood, increased energy, racing thoughts, pressured speech, poor judgment, impulsivity, and decreased need for sleep. The client displays grandiosity, impulsive spending, hyperactivity, pressured speech, insomnia, and hallucinations, all pointing to mania.
• Major depressive disorder: Involves symptoms like anhedonia, depressed mood, fatigue, and decreased energy. This is inconsistent with the client's overactivity and euphoric behavior.
• Delirium: Usually presents with acute confusion, fluctuating consciousness, and disorientation, often due to a medical condition or substance use. This client is consistently manic and does not show signs of fluctuating alertness or disorientation to time and person.
• Anhedonia: Inability to feel pleasure, commonly seen in depression, not in mania.
• Alogia: Poverty of speech or reduced speech output, often associated with schizophrenia, not consistent with this client’s pressured and loud speech.
• Magical thinking: Believing that one's thoughts can influence reality, often seen in schizotypal personality disorder, not prominent here.
• Euphoric mood: A classic symptom of mania, where the individual may feel overly joyful, energetic, and invincible, as reflected in the client's excessive confidence, impulsivity, and erratic behavior.
• Hypervigilance: Commonly linked with anxiety disorders or PTSD, and not the most fitting descriptor for this client’s presentation.

A. "Take your temperature every night before going to bed." Basal body temperature (BBT) must be measured after a full night’s sleep, not at bedtime, to accurately detect ovulatory shifts in temperature.
B. "Take your temperature 1 hour after getting out of bed." Delaying the measurement even by an hour can alter the results, as physical activity and environmental exposure can cause inaccurate readings.
C. "Take your temperature immediately after waking and before getting out of bed." This is the correct instruction. BBT should be taken at the same time each morning, right after waking, before any activity, to detect the slight rise in temperature (0.3–0.6°C or 0.5–1.0°F) that typically follows ovulation.
D. "Take your temperature within 30 minutes after your first morning void." Waiting until after voiding can also affect the reading. The temperature should be taken prior to any physical movement, including going to the bathroom, for best accuracy.