A nurse is caring for a patient who is in labor at 40 weeks of gestation and reports that she has saturated two perineal pads in the past 30 minutes.

The nurse suspects placenta previa.

What would be an appropriate nursing action in this situation?

Choice A rationale
Increased deposits of fat in the chest and shoulder area are not typically associated with respiratory distress syndrome in a newborn. Macrosomic newborns, or those with a high birth weight, may have increased fat deposits, but this is not the primary cause of respiratory distress.
Choice B rationale
A brachial plexus injury is a type of birth injury that can occur due to difficulties during delivery, such as a prolonged labor or a breech presentation. It involves damage to the bundle of nerves that supply the arms and hands. However, it does not directly cause respiratory distress syndrome.
Choice C rationale
Increased blood viscosity could potentially contribute to respiratory distress, but it is not the most likely cause in a macrosomic newborn whose mother has poorly controlled type 2 diabetes. High blood sugar levels in the mother can lead to high insulin levels in the newborn, which is a more direct cause of respiratory distress.
Choice D rationale
Hyperinsulinemia, or high levels of insulin in the blood, is the most likely cause of respiratory distress in this case. When a mother has poorly controlled diabetes, the baby’s pancreas may respond to high glucose levels by producing extra insulin. After birth, the baby may have hypoglycemia (low blood sugar) and increased red blood cell production, both of which can contribute to respiratory distress.

Choice A rationale
While Type 1 diabetes is a significant health concern, it is not the most prevalent form of diabetes. Type 2 diabetes is more common, affecting a larger proportion of the population.
Choice B rationale
Type 2 diabetes often remains undiagnosed because its symptoms can be subtle and develop slowly. People with Type 2 diabetes may not recognize these symptoms as signs of high blood sugar, leading to a delay in diagnosis and treatment.
Choice C rationale
Type 1 diabetes cannot transition to Type 2 diabetes. These are distinct conditions with different underlying causes. Type 1 diabetes is an autoimmune condition, while Type 2 diabetes is primarily associated with lifestyle factors and genetic predisposition.
Choice D rationale
Gestational diabetes mellitus (GDM) does not imply that the woman will require insulin treatment until 6 weeks postpartum. While some women with GDM may require insulin during pregnancy, this is not always the case. Furthermore, GDM usually resolves after delivery.