A nurse is reinforcing teaching with a newly licensed nurse about the complications associated with maternal gestational diabetes. Which of the following complications should the nurse include?

Choice C rationale:

This response is correct because black stools are a common side effect of taking iron supplements. Iron can cause the stool to appear black or

tarry due to the way it is broken down during digestion. It does not necessarily indicate a serious issue, especially if the client is not experiencing any abdominal pain or cramping. Educating the client about this expected side effect helps alleviate any concerns they might have about the change in stool colour.

Choice A rationale:

"Go to the emergency room and your provider will meet you there.”. This response is not appropriate in this situation. The client's report of black stools without abdominal pain or cramping is likely due to the iron supplements and does not warrant a visit to the emergency room. This response may cause unnecessary panic and anxiety for the client.

Choice B rationale:

"What else have you been eating?.”. This response is also not the best choice. While it's essential for healthcare providers to gather comprehensive information about a client's diet and lifestyle, in this case, the client's black stools can be directly attributed to the iron supplements. Focusing on other dietary factors might distract from addressing the client's concern about the side effect of iron supplementation.

Choice D rationale:

"Come to the office, and we will check things out.”. This response is not the most appropriate one either. A visit to the office might not be necessary solely based on the client's report of black stools without accompanying pain or cramping. This situation can be managed through education, and the client can be reassured that it is a typical side effect of iron supplements. An unnecessary visit to the office could inconvenience the client and waste both their time and the healthcare provider's time.

Choice A reason:
Blood pressure. The nurse does not need to report the blood pressure because it is not mentioned in the given information that there is any abnormality or concern related to the client's blood pressure. Therefore, it is not a priority finding to report.
Choice B reason:
Cerebral manifestations. There is no mention of cerebral manifestations in the nurse's notes. Since there are no reported neurological symptoms or abnormalities, the nurse does not need to report cerebral manifestations to the provider.
Choice C reason:
Fetal heart rate. The nurse should report the fetal heart rate to the provider because it is an essential parameter to monitor during prenatal care. A normal fetal heart rate ranges from 110 to 160 beats per minute, and in this case, the fetal heart rate is 158/min, which falls within the normal range. However, it is still necessary to inform the provider about this vital sign for documentation and reassurance.
Choice D reason:
Respiratory rate. The respiratory rate is not mentioned in the nurse's notes, and there are no indications of any respiratory issues or concerns. Therefore, it is not necessary to report the respiratory rate to the provider based on the information provided.
Choice E reason:
Deep tendon reflexes. The nurse notes that the patellar reflex is 3+ and clonus is negative. These findings are within the normal range and do not require reporting to the provider.
Choice F reason:
Gastrointestinal assessment findings. The nurse's notes do not mention any abnormal gastrointestinal assessment findings. Since there are no indications of gastrointestinal issues, the nurse does not need to report any gastrointestinal findings to the provider.