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.
The Correct Answer is A
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 B
Explanation
Massaging the uterus helps it contract and prevent excessive bleeding after delivery.Uterine atony is a condition where the uterus does not contract enough to clamp the blood vessels that supply the placenta, leading to postpartum hemorrhage.Uterine massage is one of the interventions to treat uterine atony and restore uterine tone.
Choice A is wrong because having the client void frequently does not directly affect the uterine contraction.However, a full bladder can interfere with uterine contraction and cause displacement of the uterus, so it is important to monitor the bladder status and empty it as needed.
Choice C is wrong because having the client in a side-lying position for comfort does not help with uterine contraction.However, this position may be beneficial for other reasons, such as reducing edema and pain in the perineal area.
Choice D is wrong because keeping the patient on strict bed rest for 24 hours to avoid stress on the uterus does not help with uterine contraction.In fact, early ambulation after delivery can help prevent thromboembolic complications and promote recovery.
Normal ranges for postpartum blood loss are less than 500 mL for vaginal delivery and less than 1000 mL for cesarean delivery.Postpartum hemorrhage is defined as blood loss greater than or equal to 1000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after birth.
Correct Answer is D
Explanation
The correct answer is choice D. It will be necessary for a Cesarean section when labor begins.This is because a pregnant person with herpes simplex virus (HSV) type II can pass the infection to the baby during childbirth, which can be life-threatening.A Cesarean section can lower the risk of infection by avoiding contact with the virus in the genital area.
Choice A is wrong because herpes can recur after delivery, especially if the person has a history of genital herpes before pregnancy.Choice B is wrong because weekly cultures of the herpes site are not recommended during pregnancy, as they are not reliable indicators of viral shedding or risk of transmission.Choice C is wrong because it is possible to have more than one herpes outbreak during pregnancy, especially if the person has a primary or nonprimary first-episode infection in the third trimester.
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