A laboring woman is lying in the supine position.
The most appropriate nursing action at this time is to:.

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:

Drying the baby after birth and wrapping the baby in a dry blanket helps prevent evaporative heat loss. Newborns have a high surface area-to-body mass ratio, making them vulnerable to heat loss through evaporation. Keeping them dry and warm helps maintain their body temperature within the normal range (around 97.8-99.1°F or 36.5-37.3°C).

Choice B rationale:

Avoiding drafts and air conditioners is important to prevent convective heat loss, not evaporative heat loss. Convective heat loss occurs when warm air around the baby is replaced by cooler air, leading to heat loss.

Choice C rationale:

Placing the baby away from the outside wall and windows is related to radiant heat loss, not evaporative heat loss. Radiant heat loss occurs when the baby loses heat to a colder surface without direct contact.

Choice D rationale:

Warming the stethoscope and the nurse's hands before touching the baby is important for preventing conductive heat loss, not evaporative heat loss. Conductive heat loss happens when the baby comes into direct contact with a colder object or surface.