The nurse is making recommendations to a school district about how to best provide sexuality education to their students.

Which statement should be included in the recommendations?

The nurse must prioritize teaching that addresses immediate neonatal safety following a gestational diabetes diagnosis. Applying knowledge of fetal insulin production and glucose metabolism is essential to understand why maternal glycemic control directly impacts newborn stabilization and prevents metabolic complications immediately after delivery.

Choice A rationale

High maternal glucose levels primarily affect the fetus through macrosomia and metabolic shifts. Pulmonary hypertension is not the direct, primary risk of poorly controlled gestational diabetes, as the priority remains managing fetal insulin production and respiratory distress risks.

Choice B rationale

While infection risk exists for any pregnant woman, sepsis is not the specific, primary complication linked to maternal hyperglycemia. Proper glucose management focuses on metabolic stability for the mother and fetus rather than being a specific preventative measure for sepsis.

Choice C rationale

Elevated maternal glucose crosses the placenta, causing fetal hyperinsulinemia. After birth, the glucose source is lost, but high insulin persists, leading to hypoglycemia. Normal neonatal blood glucose levels are typically greater than or equal to 40 mg/dL.

Choice D rationale

Increasing glucose intake is contraindicated in gestational diabetes as it exacerbates hyperglycemia. High maternal glucose leads to macrosomia, which increases risks for birth trauma and cesarean delivery. Patients should maintain a balanced diet to manage blood sugar.

Prenatal assessment at 22 weeks focuses on monitoring fetal growth and maternal well-being. Nurses must apply knowledge of gestational milestones and anatomical landmarks. Assessing the fundus provides a non-invasive way to confirm that fetal development is progressing appropriately.

Choice A rationale

Fundal height measurement begins around 20 weeks. At 22 weeks, the fundus is typically located slightly above the umbilicus. This measurement in centimeters should correlate with the weeks of gestation to screen for appropriate fetal growth.

Choice B rationale

Routine vaginal exams are not indicated at 22 weeks unless the patient reports symptoms of preterm labor, leaking fluid, or bleeding. Unnecessary exams increase the risk of infection and are not part of a standard visit.

Choice C rationale

Leopold's maneuvers are used to determine fetal lie, presentation, and position. These are typically performed in the third trimester, around 36 weeks, when the fetus is large enough to palpate clearly through the abdomen.

Choice D rationale

Pregnancy history, including gravidity and parity, is collected during the initial prenatal intake visit. While updated at each visit for new symptoms, it is not a specific physical assessment tool like measuring the fundal height.