The nurse is assessing a client at 28 weeks' gestation with gestational diabetes. What complication is the client at greatest risk for?

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Macrosomia. Gestational diabetes increases the risk of delivering a macrosomic baby, which refers to a newborn significantly larger than average. This occurs because maternal hyperglycemia crosses the placenta, stimulating the baby's pancreas to produce extra insulin, leading to increased fetal growth. Macrosomia poses risks during delivery such as shoulder dystocia and birth injuries. Option A) Preterm labor is less likely in gestational diabetes compared to other maternal conditions like hypertension. Option B) Placenta previa is not directly associated with gestational diabetes. Option D) Abruptio placentae, while a serious complication, is not the most common risk in gestational diabetes. Educationally, understanding these complications is crucial for nurses caring for pregnant women with gestational diabetes. Proper management, monitoring, and education on blood sugar control can help reduce the risk of complications like macrosomia, ensuring better outcomes for both the mother and the newborn.

Correct Answer: C

Rationale: In the context of a client with hyperemesis gravidarum, a condition characterized by severe nausea, vomiting, weight loss, and electrolyte imbalances during pregnancy, the finding that requires immediate intervention is C) Dry mucous membranes and poor skin turgor. This finding indicates dehydration, a serious concern in pregnant women as it can lead to maternal and fetal complications. Dehydration can result in electrolyte imbalances, reduced blood volume, and decreased placental perfusion, putting both the mother and baby at risk. Immediate rehydration therapy is essential to prevent further complications. Option A) Urine output of 50 mL/hr is within the normal range for a pregnant woman, so it does not require immediate intervention. Option B) Weight loss of 5 pounds in 2 weeks, although concerning, is a common feature of hyperemesis gravidarum and may not warrant immediate intervention unless it is severe and accompanied by other critical symptoms. Option D) Nausea relieved by eating crackers is a common self-management strategy for nausea in pregnancy and does not indicate an immediate need for intervention. Educationally, this question highlights the importance of recognizing dehydration in pregnant women with hyperemesis gravidarum and the necessity of prompt intervention to prevent complications for both the mother and the fetus. Nurses need to be vigilant in assessing hydration status and responding promptly to signs of dehydration in this high-risk population.

Correct Answer: A

Rationale: In the case of a client at 34 weeks' gestation diagnosed with polyhydramnios, the nurse should monitor for the complication of preterm labor. Polyhydramnios, an excessive accumulation of amniotic fluid, can lead to uterine overdistension, which in turn can stimulate contractions and lead to preterm labor. Option A, preterm labor, is the correct answer due to the physiological relationship between polyhydramnios and uterine overdistension. Monitoring for signs of preterm labor, such as regular contractions or cervical changes, is crucial in this scenario to prevent premature birth and potential complications for the newborn. The other options are incorrect in this context: - Placental abruption (Option B) is more commonly associated with conditions like hypertension or trauma, not directly linked to polyhydramnios. - Fetal growth restriction (Option C) is usually associated with conditions like preeclampsia or placental insufficiency rather than polyhydramnios. - Cord prolapse (Option D) is more likely to occur in cases of polyhydramnios during labor or delivery, not as a direct complication that the nurse would monitor for during pregnancy at 34 weeks' gestation. Understanding these associations between polyhydramnios and potential complications is crucial for nurses caring for pregnant clients to provide appropriate monitoring and interventions to ensure optimal maternal and fetal outcomes.

Correct Answer: C

Rationale: In the context of monitoring a client with gestational hypertension, the symptom that requires immediate intervention is a severe headache and vision changes, marked by option C. This is because these signs can indicate a severe complication called preeclampsia, which is a serious condition characterized by high blood pressure and damage to other organs, such as the kidneys and liver. A weight gain of 1 pound in a week (option A) can be a common occurrence in pregnancy and may not necessarily warrant immediate intervention unless accompanied by other concerning symptoms. Slight swelling of the hands and feet (option B) is also common in pregnancy, especially in the third trimester, and is known as edema. While it should be monitored, it alone may not signify a need for immediate intervention. A blood pressure of 135/85 mmHg (option D) is elevated but not necessarily at a critical level requiring immediate intervention in this context. However, it should be closely monitored as it could indicate worsening hypertension or preeclampsia if accompanied by other symptoms. Educationally, this scenario highlights the importance of recognizing key symptoms that signify a worsening condition in gestational hypertension, such as severe headache and vision changes, and the need for prompt intervention to prevent maternal and fetal complications. Nurses must be vigilant in assessing and responding to these signs to ensure optimal outcomes for both the mother and newborn.

Correct Answer: B

Rationale: Rationale: The correct answer is B) It provides antibodies that protect against infection. Breastfeeding colostrum, the first milk produced after childbirth, is rich in antibodies such as immunoglobulin A, which plays a crucial role in protecting the newborn against infections. This early immune protection is vital for the baby's developing immune system, offering defense against a range of illnesses. Option A is incorrect because although colostrum is nutrient-dense, its main role is not to solely increase the baby's birth weight. Option C is incorrect as colostrum does not eliminate the need for formula supplementation; it complements and enhances the baby's nutrition. Option D is incorrect as while breastfeeding can promote bonding and reduce stress, it may not directly reduce maternal fatigue. In an educational context, it is essential for nurses to teach prenatal classes about the unique benefits of colostrum to encourage and support breastfeeding among new mothers. Understanding the specific advantages of colostrum can empower mothers to make informed choices for the health and well-being of their newborns.