The nurse is calculating the estimated date of confinement (EDC) using Nagele's rule for a client whose last menstrual period started on December 1. Which date is most accurate?

Choice A rationale:

With good control of maternal glucose levels, sudden and unexplained stillbirth is no longer a major concern. While controlling maternal glucose levels is important in diabetic pregnancies, it does not eliminate all risks, including the risk of stillbirth. However, the most significant cause of perinatal loss in diabetic pregnancies is congenital malformations. Poorly controlled diabetes during pregnancy can lead to structural abnormalities in the fetus, increasing the risk of perinatal loss.

Choice B rationale:

The most important cause of perinatal loss in diabetic pregnancy is congenital malformations. This is the correct answer. Poorly controlled diabetes increases the risk of congenital malformations in the fetus, making it a significant concern in diabetic pregnancies. Proper management of diabetes and prenatal care are essential to reduce this risk.

Choice C rationale:

Infants of mothers with diabetes have the same risks for respiratory distress syndrome because of careful monitoring. Infants of mothers with diabetes are at an increased risk of respiratory distress syndrome due to delayed lung maturation. Careful monitoring is essential, but it does not eliminate this risk. Proper management and timely interventions are necessary to minimize the impact of respiratory distress syndrome in these infants.

Choice D rationale:

At birth, the neonate of a diabetic mother is no longer at any greater risk. Infants of diabetic mothers are at increased risk for various complications, both during and after birth. These risks include hypoglycemia, respiratory distress syndrome, and hypocalcemia, among others. Close monitoring and appropriate interventions are required to ensure the well-being of the newborn.

Choice A rationale:

The cuff labeled "toddler" is an appropriate criterion for selecting the right-sized blood pressure cuff for a 2-year-old boy. Pediatric blood pressure cuffs are available in different sizes, and using a cuff specifically labeled for toddlers ensures a proper fit and accurate blood pressure measurement.

Choice B rationale:

The cuff bladder width being approximately 40% of the circumference of the upper arm is a correct criterion. Using a cuff with an appropriate width ensures that the cuff covers a significant portion of the upper arm, allowing for accurate blood pressure measurement. A cuff that is too narrow or too wide can lead to inaccurate readings.

Choice C rationale:

The cuff bladder length covering 80% to 100% of the circumference of the upper arm is an incorrect criterion. The length of the cuff bladder should cover about 80% of the upper arm's circumference, not 80% to 100%. Using a cuff that is too long can result in falsely low blood pressure readings.

Choice D rationale:

The cuff bladder covering 50% to 66% of the length of the upper arm is an incorrect criterion. The bladder width, which covers the circumference of the upper arm, is more critical than the length. The width should be approximately 40% of the upper arm's circumference for accurate blood pressure measurement in children.