Intrauterine growth restriction (IUGR) is associated with numerous pregnancy-related risk factors except:

Choice A reason: Insulin is the preferred medication for gestational diabetes mellitus, as it does not cross the placenta and has no adverse effects on the fetus. It can be administered subcutaneously or intravenously, depending on the blood glucose level and the type of insulin.

Choice B reason: Glipizide is an oral antidiabetic agent that belongs to the sulfonylurea class. It stimulates the pancreas to secrete more insulin and lowers the blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cross the placenta and cause hypoglycemia, macrosomia, or teratogenic effects on the fetus.

Choice C reason: Acarbose is an oral antidiabetic agent that belongs to the alpha-glucosidase inhibitor class. It delays the absorption of carbohydrates from the intestine and reduces the postprandial blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cause gastrointestinal side effects, such as flatulence, diarrhea, or abdominal pain, and may interfere with the absorption of other nutrients.

Choice D reason: Repaglinide is an oral antidiabetic agent that belongs to the meglitinide class. It stimulates the pancreas to secrete more insulin and lowers the blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cross the placenta and cause hypoglycemia, macrosomia, or teratogenic effects on the fetus.

Choice A reason: Assessing the fetal heart rate pattern is the priority nursing action following an amniotomy because it can indicate the well-being of the fetus and the presence of any complications, such as cord compression, prolapse, or infection.

Choice B reason: Observing the color and consistency of fluid is an important nursing action following an amniotomy, but it is not the priority. It can provide information about the gestational age, the presence of meconium, or the risk of infection.

Choice C reason: Assessing the client's temperature is an important nursing action following an amniotomy, but it is not the priority. It can help detect signs of infection, such as chorioamnionitis, which can affect both the mother and the fetus.

Choice D reason: Evaluating the client for the presence of chills and increased tenderness using palpation is an important nursing action following an amniotomy, but it is not the priority. It can also help detect signs of infection, such as chorioamnionitis, which can cause fever, abdominal pain, and uterine contractions.