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:

With good control of maternal glucose levels, sudden and unexplained stillbirth is no longer a major concern. While controlling maternal glucose levels is important in diabetic pregnancies, it does not eliminate all risks, including the risk of stillbirth. However, the most significant cause of perinatal loss in diabetic pregnancies is congenital malformations. Poorly controlled diabetes during pregnancy can lead to structural abnormalities in the fetus, increasing the risk of perinatal loss.

Choice B rationale:

The most important cause of perinatal loss in diabetic pregnancy is congenital malformations. This is the correct answer. Poorly controlled diabetes increases the risk of congenital malformations in the fetus, making it a significant concern in diabetic pregnancies. Proper management of diabetes and prenatal care are essential to reduce this risk.

Choice C rationale:

Infants of mothers with diabetes have the same risks for respiratory distress syndrome because of careful monitoring. Infants of mothers with diabetes are at an increased risk of respiratory distress syndrome due to delayed lung maturation. Careful monitoring is essential, but it does not eliminate this risk. Proper management and timely interventions are necessary to minimize the impact of respiratory distress syndrome in these infants.

Choice D rationale:

At birth, the neonate of a diabetic mother is no longer at any greater risk. Infants of diabetic mothers are at increased risk for various complications, both during and after birth. These risks include hypoglycemia, respiratory distress syndrome, and hypocalcemia, among others. Close monitoring and appropriate interventions are required to ensure the well-being of the newborn.

Choice A rationale:

The correct answer. Surfactant is a substance that decreases surface tension in the alveoli of the lungs, preventing them from collapsing and sticking together. By improving the ability of the baby's lungs to exchange oxygen and carbon dioxide, surfactant therapy helps the infant breathe more effectively.

Choice B rationale:

Surfactant therapy is not related to sedation. Its primary function is to assist with lung function, not sedation.

Choice C rationale:

Surfactant therapy does not specifically address apnea. Its main purpose is to enhance the respiratory function of premature infants.

Choice D rationale:

Surfactant therapy is not used to fight respiratory tract infections. It is a treatment focused on improving the respiratory distress syndrome in premature infants.