A client who is a primipara is completing admission forms at her first obstetrical clinic visit.
Which information shared is needed by the practical nurse (PN) to accurately assign an estimated date of birth (EDB)?

Choice A rationale

Preterm birth can be a complication of gestational diabetes due to polyhydramnios or preeclampsia, but macrosomia carries a higher risk of birth trauma and neonatal complications. Prematurity can lead to respiratory distress syndrome and other developmental challenges.

Choice B rationale

Macrosomic newborn is the greatest risk to the fetus if euglycemia is not maintained. High maternal glucose levels lead to excessive fetal insulin production, resulting in increased fat deposition and growth. This can cause birth injuries, hypoglycemia, and respiratory distress in the neonate.

Choice C rationale

Low birth weight is typically associated with maternal malnutrition or placental insufficiency, not poorly controlled gestational diabetes. Uncontrolled gestational diabetes usually leads to fetal overgrowth (macrosomia) due to constant glucose supply.

Choice D rationale

Cleft palate is a congenital anomaly primarily linked to genetic and environmental factors during early fetal development, not directly or primarily to poorly controlled gestational diabetes. Metabolic imbalances of diabetes are not a primary cause of such structural malformations.

Choice A rationale

Applying a cold pack to the perineum after a vaginal delivery effectively reduces localized edema and inflammation. Cold therapy causes vasoconstriction, which decreases blood flow to the area, thereby minimizing fluid extravasation into the interstitial spaces and reducing swelling of the episiotomy site.

Choice B rationale

While cold packs do provide a degree of comfort by numbing nerve endings and reducing pain signals, their primary physiological benefit in the postpartum period is the reduction of swelling and inflammation, which indirectly contributes to comfort. Comfort is a secondary effect.

Choice C rationale

The statement is incorrect. Cold therapy is a recognized and effective intervention postpartum. While it may help reduce bruising by limiting subcutaneous bleeding, its most significant and immediate benefit relates to the reduction of swelling and pain.

Choice D rationale

While cold can induce vasoconstriction and thus potentially reduce bleeding, it is not the primary or most effective method for controlling significant postpartum hemorrhage. Fundal massage and uterotonics are the primary interventions for controlling postpartum bleeding.