A nurse is calculating the estimated date of delivery for a patient who reports that the first day of her last menstrual period was August 10. Using Nägele’s Rule, what is the patient’s estimated date of delivery?

Choice A rationale: A positive Coombs test indicates that the newborn has antibodies against his own red blood cells, which can lead to hemolytic disease of the newborn. This condition can cause severe anemia and jaundice, which can lead to complications such as kernicterus if not treated promptly.

Choice B rationale: The newborn’s glucose level is within the normal range (40 to 60 mg/dL), so this finding does not require immediate follow-up.

Choice C rationale: The yellow color of the sclera indicates jaundice, which can be a sign of hyperbilirubinemia. This condition can lead to complications such as kernicterus if bilirubin levels become too high.

Choice D rationale: The absence of meconium stool in a 36-hour-old newborn is unusual, as most newborns pass meconium within the first 24 to 48 hours after birth. This could indicate a problem such as meconium ileus or Hirschsprung disease, which would require further evaluation.

Choice E rationale: The head assessment finding of caput succedaneum is a common and typically harmless condition in newborns caused by pressure on the head during delivery. It does not require immediate follow-up.

Choice F rationale: The newborn’s heart rate is slightly elevated (normal range for a newborn is 120-160 beats per minute). This could be a response to factors such as fever, pain, or distress, and should be reported to the provider.

Choice G rationale: The newborn’s respiratory rate is also elevated (normal range for a newborn is 30-60 breaths per minute). This could be a sign of respiratory distress and should be reported to the provider.

Choice H rationale: Dry mucous membranes can be a sign of dehydration, which can occur if the newborn is not feeding well or is losing too much fluid, for example, through excessive sweating due to fever. This should be reported to the provider.

Choice A rationale
Oatmeal is a good source of dietary fiber, but it does not have the highest fiber content per cup compared to the other options. A cup of cooked oatmeal contains about 4 grams of fiber.
Choice B rationale
Lentils are an excellent source of dietary fiber. One cup of cooked lentils contains approximately 15.6 grams of fiber, which is significantly higher than the other options. This makes lentils a great choice for someone looking to increase their fiber intake, especially for those following a vegan diet.
Choice C rationale
Cabbage does contain fiber, but not as much as lentils or oatmeal. One cup of raw cabbage contains about 2.2 grams of fiber. While it’s a healthy vegetable to include in a diet, it’s not the best choice for someone specifically looking to increase their fiber intake.
Choice D rationale

Asparagus is another healthy vegetable that contains fiber, but not as much as the other options. One cup of cooked asparagus contains about 3.7 grams of fiber. While it’s a good choice for a balanced diet, there are better options for increasing fiber intake.