During assessment, what finding in an HIV-positive pregnant client requires further follow-up?

In this scenario, increased shortness of breath and bilateral rales in an HIV-positive pregnant client are significant findings that warrant further follow-up. These symptoms may indicate potential respiratory complications, such as pneumonia or other opportunistic infections commonly associated with HIV. The presence of bilateral rales, which are abnormal lung sounds indicating fluid or congestion in the lungs, may suggest pulmonary issues that could dramatically affect the health of both the mother and the fetus.

In contrast, decreased appetite, fatigue, slight weight loss, and skin rashes or lesions can be associated with HIV or its treatment, and while they may require monitoring, they do not typically necessitate immediate or urgent follow-up in the same way that respiratory symptoms do. The presence of shortness of breath and rales is particularly concerning and suggests that the healthcare provider should take a closer look to rule out serious complications.