A pregnant client has a history of opioid dependence. Which of the following are appropriate nursing interventions for managing her care? Select all that apply.

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.