A registered nurse is educating a newly license nurse about risk factors associated with gestational diabetes mellitus (GDM) and gestational hypertension (GH). The nurse presents four possible risk factors and asks the new nurse to categorize each one correctly.

Categorize each risk factor to the appropriate condition. Some risk factors may apply to only one condition, while others may not apply to either

A. Restraining a client for eating potato chips. This scenario describes an example of assault, which is a threat to perform physical harm or use unauthorized restraints. Threatening a client to coerce behavior violates their rights and the standards of professional nursing conduct. Negligence involves a failure to act, whereas this is an intentional tort involving an explicit threat of force.

B. Dissolving medication in food without knowledge. Administering medication covertly to a competent client who has refused it constitutes battery. Battery is the intentional and unauthorized physical contact with another person, including the administration of unwanted treatments. Nurses must respect a client's right to refuse medication regardless of the clinical benefit of the drug.

C. Applying restraints to prevent a client from leaving. This action is an example of false imprisonment, which involves the unlawful restraint or confinement of an individual against their will. An alert and oriented client has the legal right to leave the hospital at any time, even against medical advice. Physical or chemical restraints cannot be used to override a competent person's autonomy and freedom of movement.

D. Reporting a loss of pulse hours after identification. Negligence is defined as a failure to provide the standard of care that a reasonably prudent nurse would provide in a similar situation. Delaying the report of a neurovascular emergency, such as an absent pulse in a casted limb, constitutes a breach of duty. This failure to act timely significantly increases the risk of permanent tissue damage or limb loss.

A. They appear as small, red spots with white centers on the buccal mucosa. Koplik spots are a pathognomonic sign of the prodromal phase of rubeola. These lesions are typically located opposite the molar teeth and resemble grains of salt on a red background. Identification allows for early diagnosis before the characteristic maculopapular rash appears.

B. They are enlarged parotid glands. Swelling of the parotid glands is the clinical hallmark of mumps, not measles. Parotitis involves inflammation of the salivary glands leading to visible jaw swelling and discomfort. Measles involves respiratory and systemic symptoms rather than localized glandular hypertrophy in the jaw.

C. They present as fluid-filled vesicles on the child's chest. Fluid-filled vesicles are characteristic of varicella or herpes zoster infections. Measles presents with a flat, red, confluent rash that begins on the face and spreads downward. Vesicular lesions indicate a different viral etiology or a secondary integumentary complication.

D. They are a gray pseudomembrane covering the pharynx. A thick, gray, adherent pseudomembrane is the classic diagnostic finding for diphtheria. This membrane can cause significant airway obstruction and is composed of dead tissue and fibrin. Measles causes mucosal inflammation but does not produce this specific obstructive fibrinous coating.