A neonate born to a mother who was abusing heroin is exhibiting signs and symptoms of withdrawal. Which signs would the nurse assess? (Select All that Apply.)

A. Stability of the woman's emotional and psychological status:

Emotional and psychological well-being are undoubtedly important factors in pregnancy outcomes. However, in the context of gestational diabetes, while stress and psychological factors can influence overall health, including blood sugar levels, they are not the primary focus when discussing reducing complications associated with diabetes during pregnancy. While managing stress and promoting emotional stability are important aspects of prenatal care, they are not directly related to reducing complications specifically associated with gestational diabetes.

B. Reduction in retinopathy risk by frequent ophthalmologic evaluations:

Diabetic retinopathy is a complication of diabetes that affects the eyes and can lead to vision impairment or blindness if left untreated. While regular ophthalmologic evaluations are crucial for individuals with diabetes to monitor for retinopathy and other eye complications, this factor is not the most important in reducing complications associated with pregnancy and diabetes. Gestational diabetes primarily affects pregnancy outcomes, and while retinopathy risk is a concern in the long term for individuals with diabetes, it is not the primary focus during pregnancy.

C. Control of blood urea nitrogen (BUN) levels for optimal kidney function:

Blood urea nitrogen (BUN) levels are markers of kidney function, and kidney complications can be a concern in individuals with diabetes, including gestational diabetes. However, during pregnancy, the focus is primarily on controlling blood glucose levels to reduce complications associated with gestational diabetes. While kidney function is important and should be monitored in pregnant women with gestational diabetes, it is not the most crucial factor in reducing complications specifically related to pregnancy and diabetes.

D. Degree of blood glucose control achieved during the pregnancy:

This is the most important factor in reducing complications associated with pregnancy and gestational diabetes. Controlling blood glucose levels is paramount in managing gestational diabetes to reduce the risk of complications for both the mother and the baby. Tight glycemic control helps to minimize the risk of adverse outcomes such as macrosomia, birth trauma, preterm birth, and other complications associated with uncontrolled blood sugar levels during pregnancy.

A. Inspect the breasts:

Inspecting the breasts visually is usually the first step in a clinical breast examination. The nurse observes the size, shape, symmetry, and skin characteristics of the breasts, including any visible abnormalities such as dimpling, puckering, or changes in skin texture or color.

B. Palpate the axillary area:

Palpating the axillary (underarm) area is typically done after inspecting the breasts. This allows the nurse to assess for any enlarged lymph nodes or palpable masses in the axillary region, which could indicate pathology or breast cancer metastasis.

C. Compress the nipple for a discharge:

If there are concerns about nipple discharge, this step may follow breast palpation. By gently compressing the nipple, the nurse can assess for any abnormal discharge, such as bloody or spontaneous discharge, which may warrant further investigation.

D. Palpate the breasts:

Palpating the breasts is usually performed after visual inspection and axillary palpation. During breast palpation, the nurse systematically examines each breast using circular motions with varying pressure to detect any lumps, masses, or areas of tenderness. This thorough palpation helps identify any abnormalities within the breast tissue.