A nurse is caring for a client who is at 31 weeks of gestation and has gestational diabetes mellitus. The client asks, "Can gestational diabetes affect my baby?" Which of the following responses should the nurse make?

"Gestational diabetes increases the risk of your baby having hemorrhagic disease after birth."

"Gestational diabetes increases the risk of your baby having a cleft lip or palate."

"Gestational diabetes increases the risk of your baby having hypoglycemia after birth."

"Gestational diabetes increases the risk of your baby having a low birth weight."

Answer and Explanation

The Correct Answer is C

A) "Gestational diabetes increases the risk of your baby having hemorrhagic disease after birth." Hemorrhagic disease of the newborn is typically related to vitamin K deficiency, not gestational diabetes. Thus, this response does not directly address the risks associated with gestational diabetes.

B) "Gestational diabetes increases the risk of your baby having a cleft lip or palate." Cleft lip and palate are congenital conditions that are more related to genetic and environmental factors during the early stages of pregnancy. Gestational diabetes does not increase the risk of these specific congenital abnormalities.

C) "Gestational diabetes increases the risk of your baby having hypoglycemia after birth." This is correct. Infants born to mothers with gestational diabetes are at risk for hypoglycemia shortly after birth due to the high levels of insulin produced in response to maternal hyperglycemia during pregnancy.

D) "Gestational diabetes increases the risk of your baby having a low birth weight." Gestational diabetes more commonly leads to macrosomia (large birth weight) rather than low birth weight. The excessive glucose levels in the mother’s blood can result in increased fetal insulin production, leading to increased growth and fat deposits.

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Correct Answer is B

Explanation

A) Place the child in a tub bath of tepid water: While tepid water can help in some situations of hyperthermia, it is not suitable for hypothermia. A more controlled and gradual rewarming method is necessary to prevent further complications such as rewarming shock.

B) Cover the child's head with a hat: Covering the child's head with a hat is an important step in rewarming because a significant amount of body heat is lost through the head. This helps in retaining body heat and stabilizing the child’s temperature.

C) Administer acetaminophen every 4 hr: Acetaminophen is typically used for reducing fever and managing pain. It is not indicated for treating hypothermia, as it does not aid in rewarming the body or addressing the underlying hypothermic condition.

D) Obtain a specimen for blood cultures: While obtaining blood cultures might be necessary if there is a suspicion of infection, it is not a primary intervention for treating hypothermia. Immediate focus should be on rewarming and stabilizing the child.

A. Weight gain B. Warm extremities after walking C. Breathlessness when carrying an object D. Increased urinary output during the day

Correct Answer is C

Explanation

A) Weight gain: Weight gain is more commonly associated with right-sided heart failure due to fluid retention and peripheral edema. While left-sided heart failure can lead to overall heart failure, causing weight gain, it is not as specific as breathlessness for left-sided failure.

B) Warm extremities after walking: Warm extremities are generally a sign of good circulation. In clients with left-sided heart failure, reduced cardiac output often leads to poor peripheral circulation, which would more likely cause cool extremities.

C) Breathlessness when carrying an object: Left-sided heart failure leads to decreased cardiac output and pulmonary congestion. As a result, clients often experience breathlessness or dyspnea, especially during physical activities, because the heart cannot efficiently pump blood, leading to fluid buildup in the lungs.

D) Increased urinary output during the day: Left-sided heart failure usually causes decreased renal perfusion, leading to reduced urinary output during the day. Clients might experience nocturia (increased nighttime urination) due to fluid reabsorption when lying down, but increased daytime output is not typical.

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A nurse is caring for a client who is at 31 weeks of gestation and has gestational diabetes mellitus. The client asks, "Can gestational diabetes affect my baby?" Which of the following responses should the nurse make?

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