A nurse is reinforcing teaching with a client who is at 6 weeks of gestation. The client tells the nurse that she smokes one pack of cigarettes per day. The nurse should instruct the client that her newborn is at increased risk for which of the following clinical manifestations?

Choice A rationale:
A 3-hour oral glucose tolerance test is typically done during the initial diagnosis of gestational diabetes, not for ongoing monitoring. Since the client is already diagnosed, this action is not necessary at this stage.
Choice B rationale:
Obtaining an HbA1C is not necessary in this situation. HbA1C provides information about average blood glucose levels over the past 2-3 months and is not specific to postprandial glucose levels.
Choice C rationale:
Telling the client to increase carbohydrates to 65% of daily nutritional intake would not be appropriate since the client already has elevated blood glucose levels. Reducing carbohydrate intake and focusing on a balanced diet are more appropriate for managing gestational diabetes.
Choice D rationale:
Given that the client's blood glucose levels after meals are consistently above the target range (generally <140 mg/dL for 1-hour post-meal), it indicates a need for better glycemic control, which may require insulin therapy.

Choice A rationale: Placing the infant in the prone position (face down) after feeding is not recommended for a baby with gastroesophageal reflux. The prone position can increase the risk of aspiration if reflux occurs while the baby is lying down.
Choice B rationale: For an infant with gastroesophageal reflux, placing the baby in an upright position after feeding can help prevent or reduce reflux episodes. Keeping the infant in an upright position allows gravity to assist in keeping stomach contents down and reduces the likelihood of reflux into the esophagus.
Choice C rationale: Placing the infant on the right side after feeding is also not recommended for managing gastroesophageal reflux. The right side position may not be as effective in preventing reflux as the upright position.
Choice D rationale: Placing the baby on either side after feeding is also not recommended for managing gastroesophageal reflux. The upright position is more effective in preventing reflux episodes and promoting digestion. Side-lying positions after feeding may not provide the same benefits and can potentially increase the risk of reflux.