A nurse is caring for a patient who has postpartum psychosis. Which of the following actions is the nurse's priority?

Choice A rationale Reviewing the client's medical record for a history of bipolar disorder is an important assessment step, as a history of mood disorders significantly increases the risk for postpartum psychosis. This step aids in comprehensive care planning but does not address the immediate, life-threatening safety concerns inherent to acute psychosis, which must be stabilized first. Choice B rationale Postpartum psychosis often involves delusions, hallucinations, and disorganized thinking, which pose a critical, immediate risk of harm to the infant or self. Asking about suicidal or homicidal ideation is the priority action because it directly assesses this paramount safety concern, allowing for immediate protective interventions and stabilization. Choice C rationale Monitoring the infant for indications of failure to thrive is a necessary ongoing assessment for the infant of a mother with postpartum psychosis, as maternal illness can compromise infant care. However, this is a long-term outcome evaluation and does not address the immediate, acute safety crisis that the mother's active psychosis presents. Choice D rationale Reinforcing the need to take antipsychotics is vital for long-term symptom management and relapse prevention, addressing the underlying biochemical imbalance. Nonetheless, this teaching is a secondary intervention; the primary concern is the patient's and infant's immediate safety, which must be secured before focusing on medication adherence.