The nurse is counseling a woman who wants to become pregnant. The woman tells the nurse that she has a 28-day menstrual cycle and the first day of her menstrual period was January 8. The nurse correctly calculates that the woman's next fertile period is?

Choice A reason: Maternal placenta previa is not a common complication of gestational diabetes mellitus. Placenta previa is a condition in which the placenta covers the cervix, which can cause bleeding and preterm labor. The risk factors for placenta previa include previous cesarean delivery, multiple pregnancy, advanced maternal age, and smoking.

Choice B reason: Maternal hyperemesis and neonatal low birth weight are not directly related to gestational diabetes mellitus. Hyperemesis is a severe form of nausea and vomiting during pregnancy that can cause dehydration and weight loss. The causes of hyperemesis are not well understood, but it may be influenced by hormonal changes, genetic factors, and psychological factors². Neonatal low birth weight is defined as a birth weight of less than 2,500 grams, which can be caused by many factors, such as prematurity, intrauterine growth restriction, maternal infection, and maternal malnutrition.

Choice C reason: Maternal premature rupture of membranes and neonatal sepsis are not specific to gestational diabetes mellitus. Premature rupture of membranes is a condition in which the amniotic sac breaks before labor begins, which can increase the risk of infection and preterm delivery. The causes of premature rupture of membranes are not clear, but some possible factors include infection, inflammation, stress, and trauma. Neonatal sepsis is a life-threatening infection in newborns, which can be caused by bacteria, viruses, or fungi. The risk factors for neonatal sepsis include prematurity, low birth weight, maternal infection, and invasive procedures⁵.

Choice D reason: Maternal preeclampsia and fetal macrosomia are the most common and serious complications of gestational diabetes mellitus. Preeclampsia is a condition characterized by high blood pressure and protein in the urine, which can lead to organ damage, seizures, and death. The exact cause of preeclampsia is unknown, but it may be related to abnormal placental development, immune system dysfunction, and genetic factors⁶. Fetal macrosomia is a condition in which the baby is larger than normal, usually weighing more than 4,000 grams at birth. This can cause difficulties during labor and delivery, such as shoulder dystocia, birth trauma, and cesarean section. The main cause of fetal macrosomia is excessive maternal glucose, which stimulates fetal insulin production and growth.

Choice A reason: This is incorrect because providing the patient with handouts is not enough to ensure effective communication. The handouts may not be in the patient's preferred language or may use unfamiliar words or concepts. The nurse should also use other methods, such as interpreters, translators, or visual aids, to convey information to the patient.

Choice B reason: This is incorrect because speaking quickly and efficiently may hinder the patient's comprehension and increase the risk of misunderstanding. The nurse should speak slowly and clearly, using simple and common words, and allow time for the patient to ask questions or clarify information.

Choice C reason: This is correct because assessing whether the patient understands the discussion is essential for effective communication and patient education. The nurse should use techniques such as teach-back, ask-me-3, or show-me to verify the patient's understanding and address any gaps or misconceptions.

Choice D reason: This is incorrect because using maternity jargon may confuse the patient and create barriers to communication. The nurse should avoid using medical terms, abbreviations, or slang that the patient may not be familiar with. The nurse should explain any necessary terms in plain language and use examples or analogies to illustrate them.