A pediatric nurse is assessing a 6-year-old child during a well-child visit. The nurse observes that the child has gained weight appropriately for age and notices improved coordination and problem-solving skills compared to a previous visit. Additionally, the nurse notes that the child can now perform complex tasks, such as tying shoelaces, which were not possible at an earlier age.

A. This is incorrect. There is no safe level of illicit opioid use during pregnancy. Encouraging or implying safety could put both the mother and fetus at serious risk, including preterm labor, low birth weight, and neonatal abstinence syndrome (NAS).

B. Providing a supportive, nonjudgmental approach encourages the client to engage in care, disclose substance use, and access rehabilitation, counseling, and social services, which improves maternal and fetal outcomes.

C. Abrupt cessation of opioids in a dependent pregnant client can lead to maternal withdrawal, fetal distress, preterm labor, or miscarriage. Safe management involves medically supervised opioid replacement therapy, not sudden discontinuation.

D. Infants exposed to opioids in utero are at risk for NAS, which includes tremors, irritability, feeding difficulties, respiratory problems, and seizures. Early identification and intervention are essential.

E. Methadone or buprenorphine therapy is the standard of care for managing opioid dependence during pregnancy. These therapies stabilize maternal opioid levels, reduce illicit drug use, and improve pregnancy outcomes. Therapy should be medically supervised.

A. Feeling hot when the room is cold is not a typical sign or complication of severe preeclampsia. This symptom is more related to general temperature sensitivity and does not indicate the hematologic or vascular complications associated with preeclampsia.

B. Evidence of bleeding, including gums bleeding, petechiae, and purpura, may indicate thrombocytopenia or a progression toward HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets), a severe complication of preeclampsia. These findings suggest impaired coagulation and increased risk of bleeding, which are life-threatening if not promptly managed. Monitoring for such hematologic complications is essential in severe preeclampsia.

C. Edema of the lower extremities is common in normal pregnancy and mild preeclampsia, but it is not a specific sign of a serious complication. While generalized edema can indicate worsening preeclampsia, isolated lower-extremity edema is not as closely associated with life-threatening complications as bleeding or hematologic abnormalities.

D. Periods of fetal movement followed by quiet periods are typical fetal behavior and do not indicate a maternal complication of preeclampsia. Monitoring for changes in fetal movement is important, but this finding alone does not reflect maternal complications of severe preeclampsia.