A nurse is reviewing the medical record of a client who has schizophrenia and is taking clozapine.
Which of the following findings should the nurse identify as a contraindication to the administration of clozapine?

The correct answer is choice A, B, D, and F.

Choice A rationale:

The presence of protein in the urine (proteinuria) is a sign of potential prenatal complication. Normally, urine should be protein negative. Proteinuria can be a sign of preeclampsia, a serious condition that includes high blood pressure and swelling, and can lead to preterm birth or other serious complications if not managed.

Choice B rationale:

The client’s blood pressure is 162/112 mm Hg, which is significantly higher than the normal range (less than 120/80 mm Hg). High blood pressure during pregnancy could indicate preeclampsia or other complications.

Choice C rationale:

The client’s respiratory rate is 16/min, which falls within the normal range (12-20 breaths per minute). Therefore, it does not indicate a potential prenatal complication.

Choice D rationale:

The client’s report of a severe headache unrelieved by acetaminophen is concerning. This could be a symptom of preeclampsia or other serious conditions and should be investigated further.

Choice E rationale:

The client’s gravida/parity (G3 P2 with one preterm birth) does not directly indicate a potential prenatal complication. However, a history of preterm birth could put the client at higher risk for another preterm birth.

Choice F rationale:

The client’s report of decreased fetal movement is concerning. Decreased fetal movement can be a sign of fetal distress or other complications and should be investigated further.

Choice G rationale:

The client’s urine does not contain ketones, which would indicate that the body is using fat for energy instead of glucose. This could occur in cases of poor nutrition or gestational diabetes. Since the urine is ketone negative, this does not indicate a potential prenatal complication.

Choice A rationale:

Taking temperature within 30 minutes after the first morning void is specific to ovulation prediction kits, not the basal body temperature method.

Choice B rationale:

Taking temperature 1 hour after getting out of bed is not accurate for tracking basal body temperature fluctuations related to the menstrual cycle.

Choice C rationale:

Taking temperature every night before going to bed does not provide consistent basal body temperature readings, as the body temperature needs to be taken at the same time every morning to detect subtle changes related to the menstrual cycle.

Choice D rationale:

This is the correct answer. To use the basal body temperature method effectively, the client should take their temperature immediately after waking and before getting out of bed every morning. This helps in detecting the slight rise in basal body temperature that occurs after ovulation, indicating the fertile period.