A nurse is caring for a client with gestational diabetes.Which guideline should the nurse use when providing nutritional counseling to this client?

Carbohydrates should make up no more than 25% of the total dietary intake.

Animal protein should not be included in the pre-bedtime snack.

Caloric intake should be 300 calories above the suggested non-pregnant caloric intake.

Use of a sugar substitute will help to control blood glucose levels.

Answer and Explanation

The Correct Answer is C

The correct answer is choice C. Caloric intake should be 300 calories above the suggested non-pregnant caloric intake. This is because women with gestational diabetes need to meet the nutritional needs of pregnancy and also control their blood glucose levels.

Choice A is wrong because carbohydrates should make up about 45% of the total dietary intake for women with gestational diabetes, not 25%.

Carbohydrates are important for providing energy and nutrients for the mother and the baby.

Choice B is wrong because animal protein can be included in the pre-bedtime snack as long as it is combined with some carbohydrates.

Protein can help prevent low blood glucose levels during the night.

Choice D is wrong because sugar substitutes do not help to control blood glucose levels. They may also have adverse effects on the baby’s development. Women with gestational diabetes should limit their intake of added sugars and choose foods with natural sugars instead.

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Correct Answer is D

Explanation

The correct answer is choice D. Wear a supportive bra.This will help suppress lactation and reduce the discomfort of engorgement.

The other choices are wrong because:

• Choice A. Manually express colostrum as necessary.This will stimulate milk production and prolong engorgement.

• Choice B. Apply hot compresses to the breasts.This will increase blood flow and swelling in the breasts and worsen engorgement.

• Choice C. Massage the breast tissue surrounding the areola.This will also stimulate milk production and prolong engorgement.

Normal ranges for breast engorgement are not applicable as it is a subjective experience that varies among women.However, some signs of engorgement include firm, tender, swollen breasts, flat or inverted nipples, and low-grade fever.Engorgement usually resolves within 24 to 36 hours after it begins.

A. It is necessary to promote muscle tone to minimize acrocyanosis. B. It is necessary to encourage tactile stimulation to promote the myelinization of nerves. C. When the neonate responds to the mother by some signal, attachment behavior is stimulated in the mother. D. When reflexes are stimulated in the neonate, a normal growth pattern ensues.

Correct Answer is C

Explanation

The correct answer is choice C. When the neonate responds to the mother by some signal, attachment behavior is stimulated in the mother.This is based on therooting reflex, which helps the baby find the breast or bottle to start feeding and also promotes bonding between the mother and the baby.

Choice A is wrong because acrocyanosis is a normal condition in newborns that causes bluish discoloration of the hands and feet due to poor circulation.It is not related to muscle tone or reflexes.

Choice B is wrong because myelinization of nerves is a process that occurs gradually during development and is not influenced by tactile stimulation.Myelin is a fatty substance that covers nerve fibers and helps them transmit signals faster and more efficiently.

Choice D is wrong because reflexes are involuntary movements or actions that do not depend on conscious thought or learning.They are not directly related to growth patterns, although they may indicate the health and development of the brain and nervous system.

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A nurse is caring for a client with gestational diabetes.Which guideline should the nurse use when providing nutritional counseling to this client?

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