A client's fetus is estimated to weigh 4500 g (9 lb, 14 oz). Which statement indicates that additional teaching about the size of the baby is needed?
1. "His blood sugars could be high after he is born."
2. "I am at risk for excessive bleeding after delivery."
3. "My perineum could experience trauma during the birth."
4. "His shoulders could get stuck and a collar bone broken."
1
Explanation:
1. Hypoglycemia, not hyperglycemia, is a potential complication experienced by a macrosomic fetus.
2. Because of the excessive size of the uterus with a macrosomic fetus, uterine atony leading to postpartum hemorrhage is a risk.
3. Perineal trauma due to the large fetus is a possible complication of vaginal delivery of a macrosomic fetus.
4. Shoulder dystocia is more common among large fetuses, and a broken clavicle could result.
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