A nurse is caring for a newborn who has macrosomia and whose mother has diabetes mellitus. The nurse should recognize which of the following newborn complications as the priority focus of care?

Choice A reason: Uterine enlargement greater than expected for gestational age is not a typical manifestation of ectopic pregnancy, because the embryo is implanted outside the uterus, usually in the fallopian tube. The uterus may be slightly enlarged due to hormonal changes, but not more than expected for the gestational age.

Choice B reason: Unilateral, cramp-like abdominal pain is a common manifestation of ectopic pregnancy, because the embryo grows and stretches the fallopian tube, causing inflammation and irritation. The pain may be mild or severe, depending on the size and location of the ectopic pregnancy, and may radiate to the shoulder or back.

Choice C reason: Severe nausea and vomiting is not a specific manifestation of ectopic pregnancy, because it can be caused by other conditions, such as hyperemesis gravidarum, gastroenteritis, or appendicitis. The client may have mild nausea and vomiting due to hormonal changes, but not more than usual for the gestational age.

Choice D reason: Large amount of vaginal bleeding is not a usual manifestation of ectopic pregnancy, because the bleeding is usually internal, into the abdominal cavity. The client may have spotting or light bleeding due to the detachment of the endometrium, but not heavy or profuse bleeding.

Choice A reason: This statement is insensitive and dismissive, as it implies that the client's feelings are not valid or important. The nurse should not minimize the client's disappointment or guilt, but rather acknowledge and respect them.

Choice B reason: This statement is inaccurate and irrelevant, as it does not address the client's emotional needs or concerns. The nurse should not give false or misleading information, or focus on the physical aspects of recovery, but rather provide emotional support and education.

Choice C reason: This statement is presumptuous and unrealistic, as it assumes that the client wants or can have another pregnancy, and that a vaginal delivery is possible or preferable. The nurse should not make assumptions or promises, or compare different modes of delivery, but rather explore the client's feelings and expectations.

Choice D reason: This statement is empathetic and respectful, as it reflects the client's feelings and validates them. The nurse should use active listening and therapeutic communication skills, such as open-ended questions, clarifications, and summarizations, to help the client cope and express her emotions.