The nurse is calculating the estimated date of confinement (EDC) using Nagele's rule for a client whose last menstrual period started on December 1. Which date is most accurate?

Choice A rationale:
Preventing the spread of illness to others is not the primary focus when teaching a mother about ulcerative colitis. Ulcerative colitis is a chronic inflammatory bowel disease and is not contagious. The primary focus of education should be related to managing the child's symptoms and improving their quality of life.
Choice B rationale:
Nutritional guidance and preventing constipation are essential aspects of managing ulcerative colitis. Proper nutrition helps support the child's overall health and well-being. Additionally, preventing constipation is crucial in managing symptoms and reducing discomfort for children with ulcerative colitis.
Choice C rationale:
Teaching daily use of enemas may be relevant in specific cases or during acute flare-ups, but it is not a general teaching point for all children with ulcerative colitis. Enema usage should be based on the healthcare provider's recommendation and tailored to the individual child's needs.
Choice D rationale:
Coping with stress and avoiding triggers is important in managing ulcerative colitis. Stress and certain triggers can exacerbate symptoms and lead to flare-ups. Teaching coping mechanisms and identifying triggers can help the child and their family manage the condition effectively.

Choice A rationale:

Morning sickness, which refers to nausea and vomiting during pregnancy, is a common symptom but not a definitive sign of pregnancy. It can also be caused by various other factors such as food poisoning or gastrointestinal issues. Therefore, it is not a positive sign of pregnancy.

Choice B rationale:

Quickening, which refers to the first fetal movements felt by the mother, is a subjective sign of pregnancy. It is not a definitive indication of pregnancy as it can be mistaken for other abdominal sensations. Quickening usually occurs between 18 to 22 weeks of gestation, making it a later sign and not an early positive sign of pregnancy.

Choice C rationale:

A positive pregnancy test, specifically a blood or urine test detecting human chorionic gonadotropin (hCG), is a reliable indicator of pregnancy. However, it is a biochemical sign and not a physical sign. It does not directly confirm the presence of the fetus or its well-being, making it less specific than auscultating the fetal heartbeat.

Choice D rationale:

Fetal heartbeat auscultated with Doppler/fetoscope is a positive sign of pregnancy. The healthcare provider can hear the fetal heartbeat using a Doppler ultrasound device or fetoscope, confirming the presence of a viable pregnancy. This sign is considered positive because it directly indicates the presence of a developing fetus, providing reassurance about the pregnancy status. Fetal heartbeat can usually be detected around 10 to 12 weeks of gestation.