A nurse in the prenatal clinic is reinforcing teaching to a client who is in her second trimester and has a new diagnosis of gestational diabetes. Which statement by the client indicates a need for further teaching?

c. Excessive uterine enlargement

A hydatidiform mole is a type of gestational trophoblastic disease, where the placenta develops abnormally into a mass of cysts that resemble grape-like clusters. A hydatidiform mole can cause excessive uterine enlargement, as the uterus grows larger than expected for the gestational age. The nurse should measure the fundal height and compare it with the expected value based on the last menstrual period or ultrasound.

The other findings are not associated with a hydatidiform mole and may indicate other conditions.

Whitish vaginal discharge is not a sign of a hydatidiform mole, but it may be normal in pregnancy due to increased cervical mucus production. However, if the discharge is foul-smelling, yellow, green, or bloody, it may indicate an infection or a complication such as preterm labor or placental abruption.

Fetal heart rate irregularities are not a sign of a hydatidiform mole, but they may indicate fetal distress or congenital anomalies. A hydatidiform mole usually does not have a viable fetus, and fetal heart tones are absent or very faint. The nurse should use a Doppler device or a fetal monitor to assess the fetal heart rate and rhythm.

d. Rapidly dropping human chorionic gonadotropin (hCG) levels are not a sign of a hydatidiform mole, but they may indicate a spontaneous abortion or an ectopic pregnancy. A hydatidiform mole usually causes very high hCG levels, as the abnormal placental tissue secretes large amounts of this hormone. The nurse should perform a urine or blood test to measure the hCG levels and monitor them for chan

The client's symptoms are suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervical opening. Placenta previa can cause painless, bright red bleeding in the third trimester, especially after sexual intercourse or a pelvic exam. The bleeding can be life-threatening for both the mother and the fetus, and the condition requires immediate evaluation and management. An ultrasound is the best diagnostic tool to confirm the location of the placenta and rule out other causes of bleeding, such as placental abruption or uterine rupture.The other options are not relevant to the client's situation and would not be indicated by an ultrasound.Fetal lung maturity is not a concern for a client who is at 38 weeks of gestation, as most fetuses have developed sufficient surfactant production by this time. Fetal lung maturity can be assessed by amniocentesis or by measuring the lecithin/sphingomyelin ratio in the amniotic fluid.Frequency and duration of contractions are not present in the client's case, as she has no signs of labor. Contractions can be monitored by external or internal tocodynamometry or by palpation.d. Rh incompatibility is a condition where the mother's blood type is Rh-negative and the fetus's blood type is Rh- positive, which can cause hemolytic disease of the newborn. Rh incompatibility can be detected by blood tests and prevented by administering Rh immunoglobulin to the mother during pregnancy and after delivery.