A nurse is teaching a client at 24 weeks of gestation about special considerations of gestational diabetes mellitus (GDM). Which of the following statements by the client indicates that the teaching was effective? (Select all that apply)

Choice A rationale

Waiting for the next contraction is inappropriate in shoulder dystocia, where immediate action is required to prevent fetal hypoxia. Delaying intervention can lead to serious complications for the newborn.

Choice B rationale

The McRoberts maneuver, involving hyperflexion of the mother's legs, widens the pelvis, facilitating shoulder delivery in cases of shoulder dystocia. This technique reduces shoulder impaction effectively.

Choice C rationale

Applying fundal pressure is contraindicated in shoulder dystocia as it may worsen the impaction by compressing the fetal shoulders against the maternal pelvis, increasing the risk of injury.

Choice D rationale

Vacuum extraction is not recommended for shoulder dystocia management. This obstetric emergency requires specific maneuvers, like the McRoberts maneuver, to relieve the impacted shoulder.

Choice A rationale

Anemia in pregnancy requires increased iron intake to support hemoglobin production, essential for oxygen transport in the blood. Iron-rich foods, such as red meat and leafy greens, are recommended.

Choice B rationale

Decreasing protein intake is counterproductive for anemic pregnant clients. Protein is vital for overall health and fetal development, and adequate intake should be maintained.

Choice C rationale

Calcium-rich foods are important but do not directly address anemia. They support bone health, and while necessary, they do not substitute the need for increased iron in anemic clients.

Choice D rationale

Vitamin C intake should be increased alongside iron-rich foods as it enhances iron absorption. However, increasing vitamin C alone does not suffice to correct anemia without adequate iron intake.