A nurse is providing teaching to a client who is scheduled for a kidney transplantation. Which of the following statements by the client indicates an understanding of the teaching?

A. Blood pressure 140/90 mm Hg: This blood pressure reading is elevated but does not specifically suggest a pulmonary embolism (PE). It could be due to other factors such as anxiety or pain, and it is not a primary indicator of PE.

B. Respiratory rate 12/min: A respiratory rate of 12/min is within the normal range (12-20 breaths per minute). A PE typically causes an increased respiratory rate as the body attempts to compensate for impaired oxygenation: normal respiratory rate does not suggest PE.

C. Temperature 40° C (104° F): A fever of 40° C (104° F) is significantly elevated and suggests an infection or inflammation. While a PE can cause mild fever, a temperature of 40° C is more commonly associated with infection rather than a pulmonary embolism.

D. Heart rate 120/min: A heart rate of 120/min is indicative of tachycardia, which is a common response to a pulmonary embolism. The body tries to compensate for reduced oxygenation by increasing heart rate. Tachycardia, along with other symptoms such as shortness of breath and chest pain, is a key indicator of PE.

Rationale for correct choices:

• Infection: Clients with HIV are immunocompromised and already at increased risk for infections. A declining WBC count, especially falling below the normal range (4,100/mm³ from 4,500/mm³), indicates worsening immunosuppression, further elevating the infection risk.
• WBC count: White blood cells are crucial for immune defense. In HIV clients, a low or decreasing WBC count suggests progressing immunodeficiency, making the body less able to fight infections, especially opportunistic ones.

Rationale for incorrect choices:

• Dysrhythmias: The client's potassium level is 3.8 mEq/L, well within normal limits (3.5–5 mEq/L). There is no electrolyte imbalance that would predispose the client to cardiac rhythm disturbances.
• Renal failure: BUN is slightly elevated from 16 to 18 mg/dL, but still within the normal range (10–20 mg/dL). This mild change is not enough to suggest renal dysfunction or failure.
• Bleeding: Platelet count is stable and within normal limits at 162,000/mm³. Thrombocytopenia becomes more concerning at values below 150,000, so there is no immediate bleeding risk.
• Seizures: The sodium level is 139 mEq/L, which is within the normal range. There are no abnormal electrolyte findings or neurological symptoms to indicate seizure risk.