A client indicates the desire to become pregnant. Which of the following are important preconception education topics for the nurse to provide? Select all that apply.

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NCLEX® CHANGE AS OF 2017 - Please note that select-all-that-apply (SATA) questions on NCLEX can now include any number of correct responses. Only ONE option or up to ALL options may be correct. UWorld questions now reflect this change. Visit NCSBN® NCLEX FAQs for more information. Preconception counseling assesses for pregnancy risk factors and implements appropriate interventions to promote a healthy pregnancy. Some behaviors the client may begin independently include eating a nutritious diet; exercising; abstaining from alcohol, tobacco, and illicit drugs; and taking folic acid supplements. Obesity (BMI >30 kg/m²) during pregnancy is associated with an increased risk for fetal/maternal complications (eg, gestational diabetes, hypertension, cesarean birth). Achieving a normal BMI (18.5-24.9 kg/m²) is optimal (Option A). No amount of alcohol is considered safe in pregnancy; complete abstinence from alcohol is recommended to avoid fetal alcohol syndrome. Smoking cessation is encouraged due to its association with fetal growth restriction; illicit drugs may also cause fetal harm (Option B). fetal alcohol syndrome Folic acid supplementation of at least 400 mcg per day for 3 months before pregnancy is recommended to reduce the incidence of neural tube defects (Option C). Neural tube development begins around the third week following conception, before a woman may realize that she is pregnant. Finally, clients should visit their health care provider to discuss pregnancy's effect on certain health conditions (eg, asthma, diabetes) and check rubella immunity (Option D). Rubella vaccination should be given if the client is nonimmune, and pregnancy should be avoided for at least 4 weeks after vaccination. Regular visits with a dentist can help prevent periodontal disease, which is associated with poor pregnancy outcomes (eg, preterm birth, low birth weight) (Option E). Educational objective: Preconception care improves pregnancy outcomes and includes folic acid supplementation; regular dental care; updated vaccinations; avoidance of alcohol, smoking, and illicit drugs; and achieving a normal weight.

A Client Indicates the Desire to Become Pregnant