A nurse is caring for a client who experienced a vaginal birth 12 hours ago. The nurse recognizes the client is in the dependent, taking-in phase of maternal postpartum adjustment. Which of the following findings should the nurse expect during this phase?

Choice A reason:
Reducing exercise to 3 days a week may not be sufficient for managing gestational diabetes. Regular physical activity is an important part of diabetes management because it helps lower blood sugar levels and can improve insulin sensitivity. The American Diabetes Association recommends that pregnant women with gestational diabetes engage in at least 150 minutes of moderate-intensity aerobic activity per week. This can be distributed over at least three days per week, with no more than two consecutive days without exercise.

Choice B reason:
The statement that the client knows she is at increased risk of developing type 2 diabetes is accurate. Women with gestational diabetes have a higher risk of developing type 2 diabetes later in life. Therefore, they should be monitored for diabetes postpartum and in the years following the birth.

Choice C reason:
Taking glyburide, an oral hypoglycemic agent, is a common treatment for gestational diabetes when diet and exercise are not enough to control blood sugar levels. It is usually taken before breakfast to help control blood sugar levels throughout the day.

Choice D reason:
The statement about limiting carbohydrates to 50% of caloric intake indicates a need for further teaching. While it is important to monitor carbohydrate intake, there is no one-size-fits-all recommendation for the percentage of calories that should come from carbohydrates. Dietary needs can vary based on individual factors, and it is generally recommended to follow a balanced diet with carbohydrates coming from whole grains, fruits, vegetables, and legumes. The client should work with a dietitian to determine the appropriate amount of carbohydrates for her specific needs.

Choice A reason:
A blood glucose level of 96 mg/dL is within the normal range for a fasting blood sugar level in pregnancy, which is typically between 70 to 95 mg/dL. It is crucial to monitor blood glucose levels during pregnancy due to the risk of gestational diabetes, which can have adverse effects on both the mother and the fetus.

Choice B reason:
The production of estrogen is indeed enhanced during pregnancy. Estrogen plays a vital role in maintaining the pregnancy, promoting fetal development, and preparing the body for childbirth. Elevated levels of estrogen are expected and contribute to many of the physiological changes experienced during pregnancy.

Choice C reason:
A heart rate of 120 bpm (beats per minute) can be considered slightly elevated during pregnancy. The normal resting heart rate for a pregnant woman is usually between 60 to 100 bpm. However, during pregnancy, the heart rate can increase to accommodate the increased blood volume and the needs of the growing fetus. Given the information provided, the most likely scenario that the nurse should address is the heart rate of 120 bpm, as it is slightly above the normal range and may need monitoring or intervention.

Choice D reason:
Weakened respiratory contractions are not typically expected during pregnancy. Pregnant women may experience shortness of breath due to the growing uterus pushing against the diaphragm, but the respiratory contractions themselves should not be weakened. If this occurs, it may warrant further investigation.