A patient with pregestational diabetes mellitus delivers a neonate who is diagnosed with macrosomia. The nurse is aware that the neonate is at risk for additional long-term conditions related to maternal diabetes mellitus.
Which long-term effects may occur? Select all that apply.
Impaired intellectual development.
Development of metabolic syndrome.
Shoulder injury related to birth size.
Changes in genetic expression.
Increased risk for chronic illnesses.
Correct Answer : A,B,D,E
Choice A rationale
Impaired intellectual development in children born to mothers with diabetes can occur due to fluctuating blood glucose levels, which can affect brain development.
Choice B rationale
Development of metabolic syndrome is more likely in children born to mothers with diabetes due to genetic predispositions and prenatal exposure to hyperglycemia.
Choice C rationale
Shoulder injury related to birth size, although a possible immediate complication, is not typically considered a long-term effect of maternal diabetes.
Choice D rationale
Changes in genetic expression can occur due to epigenetic modifications from exposure to maternal diabetes, potentially leading to various health issues later in life.
Choice E rationale
Increased risk for chronic illnesses, such as type 2 diabetes and cardiovascular diseases, is higher in children born to mothers with diabetes, due to genetic and environmental factors.
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Correct Answer is C
Explanation
Choice A rationale
Reporting abnormal findings to the obstetrician is unnecessary because an increase in the Bishop score from 4 to 10 indicates successful cervical ripening and readiness for labor
induction.
Choice B rationale
Placing the client on her side is not directly related to the assessment of cervical ripening or the Bishop score. It may be considered for comfort during labor.
Choice C rationale
Monitoring for the onset of labor is appropriate since the increase in the Bishop score to 10 suggests that the cervix is favorable for labor. Continuous monitoring is essential to detect
the onset and progression of labor.
Choice D rationale
Performing nitrazine analysis of amniotic fluid is not relevant to the assessment of cervical ripening or the Bishop score. This test is typically used to confirm the presence of amniotic
fluid in cases of suspected rupture of membranes.
Correct Answer is D
Explanation
Choice A rationale
Precipitous labor and birth are not directly associated with postpartum endometritis. The primary risk factors are related to infections during labor.
Choice B rationale
Postpartum endometritis is typically treated with a combination of antibiotics for 7-10 days, not a single dose of ampicillin or cephalosporin. A single dose would be insufficient for
treating the infection.
Choice C rationale
Postpartum endometritis is more common following cesarean birth due to increased risk of infection despite the use of sterile techniques during surgery.
Choice D rationale
Postpartum endometritis is associated with internal monitoring, amnioinfusion, prolonged labor, and prolonged rupture of membranes. These factors increase the risk of infection,
which can lead to endometritis.