A nurse is caring for a client with gestational diabetes.Which guideline should the nurse use when providing nutritional counseling to this client?

The correct answer is choice B: The risk of transplacental transmission of chlamydia between mother and baby is low.This means that the infection is unlikely to pass from the mother’s blood to the baby’s blood through the placenta.However, this does not mean that the infection is harmless for the baby.

Choice A is wrong because transmission of chlamydia usually occurs when the baby passes through the vagina.This can cause eye infections or pneumonia in the newborn.

Choice C is wrong because the baby has probably not developed antibodies to the chlamydia in utero.Antibodies are proteins that help fight infections, and they are usually passed from the mother to the baby through the placenta.However, chlamydia does not stimulate a strong antibody response in the mother, so there is little protection for the baby.

Choice D is wrong because the baby will not receive systemic treatment at birth to prevent a chlamydia infection.Systemic treatment means medication that affects the whole body, such as oral or intravenous antibiotics.The baby will only receive topical treatment, such as eye drops or ointment, to prevent eye infections.Normal ranges: Chlamydia infection is common among pregnant women, especially those under 25 years old or with risk factors such as multiple or new sexual partners.The prevalence of chlamydia among pregnant women in the United States ranges from 1% to 40%, depending on the population and screening methods.Chlamydia infection can be diagnosed by urine or swab tests, and treated with antibiotics such as azithromycin or doxycycline.Chlamydia screening is recommended for all pregnant women at their first prenatal visit and again in the third trimester if they are at high risk.

A transverse lie means that the baby is lying sideways across the uterus, instead of head-down or breech.

This position makes vaginal delivery impossible and increases the risk of umbilical cord prolapse, which can compromise fetal oxygen supply.Therefore, a cesarean delivery is indicated for a fetus in a transverse lie.

Choice A is wrong because having extremely slender hips does not necessarily mean that a woman cannot deliver vaginally.

The size and shape of the pelvis, not the external appearance, determines the adequacy of the birth canal.A trial of labor may be attempted for women with borderline pelvic measurements.

Choice C is wrong because fetal hyperactivity is not a reason for a cesarean delivery.

Fetal movements may vary depending on the time of day, maternal activity, maternal blood sugar level, and other factors.Fetal well-being can be assessed by fetal heart rate monitoring and biophysical profile.

Choice D is wrong because having a posterior cervix does not indicate the need for a cesarean delivery.

A posterior cervix means that the cervix is tilted toward the back of the uterus, which may make cervical dilation slower and more painful.However, with adequate contractions and maternal pushing, the cervix can move to an anterior position and allow vaginal delivery.