A nurse is teaching a client who is at 38 weeks of gestation about a contraction stress test. Which of the following statements should the nurse include in the teaching?

Rationale:

A. WBC count: The client’s WBC decreased from 33,000/mm³ on postpartum day 3 to 10,000/mm³ on day 5, indicating resolution of the infection and an appropriate response to antibiotic therapy. This reflects improvement in the client’s inflammatory and immune status.

B. Fundal height: The fundus has descended from 1 cm above the umbilicus to 4 cm below the umbilicus and remains firm and midline, demonstrating normal uterine involution and a return toward pre-pregnancy size, indicating recovery from postpartum changes.

C. Temperature: The client’s temperature decreased from 38.6° C on day 3 to 37.1° C on day 5, showing resolution of the febrile response associated with infection and stabilization of her overall condition.

D. Lochia: The lochia changed from moderate, dark brown, foul-smelling on day 3 to a small amount of brownish-red, odorless lochia on day 5, reflecting improvement in uterine healing and the absence of ongoing infection.

E. Hgb: The client’s hemoglobin decreased slightly from 11.1 g/dL to 10 g/dL. While slightly lower, it remains above critical levels and is not an indicator of improvement; in fact, it shows a mild drop, likely from blood loss during delivery, so it is not considered a sign of recovery.

F. Heart rate: The client’s heart rate decreased from 110/min on day 3 to 78/min on day 5, indicating resolution of tachycardia associated with infection, pain, or stress, and reflecting stabilization of cardiovascular status.

Rationale:

A. "You have the right to decide who receives information.": Clients have the legal and ethical right to confidentiality regarding their medical care under HIPAA and patient privacy regulations. Respecting the client’s decision about who can receive health information reinforces autonomy and ensures that the nurse supports the client’s rights in healthcare decision-making.

B. "Your partner can be a great source of support for you at this time.": While acknowledging the potential benefits of support is empathetic, this statement does not address the client’s request for privacy. It may inadvertently pressure the client to share information, which could violate confidentiality and autonomy.

C. "Is there a reason you don't want your partner to know about your procedure?": Asking for justification may make the client feel challenged or judged. The client is not required to explain their choice, and pressing for reasons can undermine trust and respect for their privacy.

D. "The provider will be tactful when talking to your partner.": This statement assumes the provider will communicate with the partner and disregards the client’s expressed wishes. It could lead to disclosure against the client’s consent, violating confidentiality and patient rights.