A nurse is reinforcing teaching with a client who is pregnant and whose routine diagnostic testing reveals a negative rubella titer.
Which of the following statements should the nurse tell the client?

Choice A rationale:

Increasing carbohydrates to 65% of daily nutritional intake is not the appropriate action for a client with blood glucose levels ranging from 180 mg/dL to 250 mg/dL following meals. In this scenario, the client's blood glucose levels are already elevated, and increasing carbohydrates may further exacerbate hyperglycemia. It's important to focus on blood glucose control rather than increasing carbohydrate intake.

Choice B rationale:

Scheduling a 2-hour oral glucose tolerance test is not the immediate action required in this case. While this test can help diagnose gestational diabetes, the client's elevated post-meal blood glucose levels are already a concern. The primary concern is addressing and managing these high levels before proceeding with additional testing.

Choice C rationale:

Anticipating an order for insulin administration is the correct action. When a client with gestational diabetes has blood glucose levels consistently above the target range, despite dietary modifications, insulin administration may be necessary to achieve glycemic control. This is a key intervention to prevent complications for both the mother and the baby.

Choice D rationale:

Obtaining an HbA1c is not typically done during pregnancy to assess glucose control, as it reflects the average blood glucose levels over the past 2-3 months. In this case, more immediate monitoring and intervention are required to address the high post-meal blood glucose levels. Now, let's move on to the final question.

Choice B rationale:

"I'll expect the penis to heal within 24 hours" is not an accurate understanding of circumcision care. Circumcision healing typically takes longer than 24 hours, and this statement could lead to unrealistic expectations. It's essential for the parent to understand that healing may take several days to a week, and they should watch for signs of infection or other complications.

Choice C rationale:

"I'll make sure his diaper is loose in the front" is not directly related to circumcision care. While keeping the diaper loose can help prevent irritation and discomfort, it does not address specific care for the circumcision site. This statement does not demonstrate an understanding of the key points of circumcision care.

Choice D rationale:

"I'll apply alcohol swab to his penis during diaper changes" is not recommended for circumcision care. Using alcohol swabs can be too harsh on the sensitive skin of a newborn and may lead to irritation. It's generally advised to clean the area with warm water and mild soap or simply allow it to air dry.

Choice E rationale:

"I wash his penis with warm water and mild soap each day" is a correct understanding of circumcision care. Keeping the circumcision site clean with warm water and mild soap is a recommended practice to prevent infection. However, it's important to avoid vigorous scrubbing or excessive cleaning, as this can also cause irritation.