A nurse is reinforcing teaching about quickening with a client who is at 6 weeks of gestation.
Which of the following information should the nurse include?

Choice A rationale:

Increasing carbohydrates to 65% of daily nutritional intake is not the appropriate action for a client with blood glucose levels ranging from 180 mg/dL to 250 mg/dL following meals. In this scenario, the client's blood glucose levels are already elevated, and increasing carbohydrates may further exacerbate hyperglycemia. It's important to focus on blood glucose control rather than increasing carbohydrate intake.

Choice B rationale:

Scheduling a 2-hour oral glucose tolerance test is not the immediate action required in this case. While this test can help diagnose gestational diabetes, the client's elevated post-meal blood glucose levels are already a concern. The primary concern is addressing and managing these high levels before proceeding with additional testing.

Choice C rationale:

Anticipating an order for insulin administration is the correct action. When a client with gestational diabetes has blood glucose levels consistently above the target range, despite dietary modifications, insulin administration may be necessary to achieve glycemic control. This is a key intervention to prevent complications for both the mother and the baby.

Choice D rationale:

Obtaining an HbA1c is not typically done during pregnancy to assess glucose control, as it reflects the average blood glucose levels over the past 2-3 months. In this case, more immediate monitoring and intervention are required to address the high post-meal blood glucose levels. Now, let's move on to the final question.

Choice A rationale:

Blotting the perineal area dry after voiding is an important part of perineal care. Moisture can contribute to perineal infection, so it is essential to keep the area dry. This practice helps prevent the growth of bacteria and reduces the risk of infection.

Choice D rationale:

Cleaning the perineal area from front to back is crucial in reducing the risk of perineal infection. This method helps prevent the transfer of bacteria from the anal area to the perineum and vaginal area, reducing the risk of infection.

Choice E rationale:

Performing hand hygiene before and after voiding is an important aspect of perineal care and infection prevention. Proper hand hygiene helps prevent the transfer of bacteria from the hands to the perineal area and vice versa, reducing the risk of infection.

Choice B rationale:

Applying ice packs to the perineal area several times daily is not a recommended practice for reducing the risk of perineal infection. While ice packs can provide pain relief and reduce swelling, they should not be applied excessively, as prolonged exposure to cold can compromise blood flow and potentially increase the risk of tissue damage or infection.

Choice C rationale:

Sitting on an inflatable donut to protect the perineum is not a recommended practice for reducing the risk of perineal infection. Inflatable donuts can increase pressure on the perineal area, potentially causing discomfort and impairing blood flow. Proper hygiene and keeping the area clean and dry are more effective strategies for infection prevention. .