The nurse is calculating the estimated date of confinement (EDC) using Nagele's rule for a client whose last menstrual period started on February 13th. Which date is most accurate?

Choice A reason: Limiting time spent wearing a wet bathing suit is a good preventive measure, as it can reduce the moisture and warmth that can promote the growth of bacteria and fungi in the genital area. The nurse should advise the 15-year old to change into dry clothes as soon as possible after swimming or bathing.

Choice B reason: Not douching is a good preventive measure, as it can preserve the natural balance of the vaginal flora and pH. The nurse should explain to the 15-year old that douching can wash away the protective mucus and lactobacilli that prevent infections, and it can also introduce harmful substances or microorganisms into the vagina.

Choice C reason: Wearing nylon undergarments is not a good preventive measure, as it can trap heat and moisture in the genital area and create a favorable environment for infections. The nurse should recommend the 15-year old to wear cotton or breathable fabrics that can absorb sweat and allow air circulation.

Choice D reason: Using floral scented bath salts is not a good preventive measure, as it can irritate the genital mucosa and alter the vaginal pH. The nurse should caution the 15-year old to avoid using any products that contain perfumes, dyes, or chemicals in the genital area, as they can cause allergic reactions or infections.

Choice E reason: Decreasing sugar intake is a good preventive measure, as it can lower the risk of yeast infections. The nurse should educate the 15-year old that sugar can feed the growth of Candida albicans, which is a common cause of vaginal candidiasis. The nurse should also encourage the 15-year old to eat a balanced diet that includes probiotics, such as yogurt, to maintain a healthy vaginal flora.

Choice F reason: Avoiding tight-fitting jeans is a good preventive measure, as it can prevent friction and pressure on the genital area. The nurse should suggest the 15-year old to wear loose or comfortable clothing that can reduce the risk of skin irritation or injury, which can lead to infections.

Choice A reason: Urinary frequency is a common symptom of pregnancy, especially in the first and third trimesters, due to the increased pressure of the uterus on the bladder. It is not a sign of complication and does not need to be reported immediately.

Choice B reason: Rupture of membranes is the breaking of the amniotic sac, which can occur spontaneously or artificially before or during labor. It is a sign of impending delivery and can increase the risk of infection. It should be reported immediately to the health care provider.

Choice C reason: Heartburn accompanied by severe headache can indicate preeclampsia, a serious condition characterized by high blood pressure and proteinuria in pregnancy. It can lead to eclampsia, which is a life-threatening seizure disorder. It should be reported immediately to the health care provider.

Choice D reason: Decreased libido is a normal change in pregnancy, due to hormonal fluctuations, physical discomfort, and emotional stress. It is not a sign of complication and does not need to be reported immediately.

Choice E reason: Vaginal bleeding can indicate various complications in pregnancy, such as placenta previa, placental abruption, or miscarriage. It can pose a threat to the mother and the fetus. It should be reported immediately to the health care provider.