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A nurse is collecting data from a client who is at 34 weeks of gestation and has hyperglycemia.
Which of the following manifestations should the nurse expect?

A.

Decreased urination.

B.

Shallow respirations.

C.

Thirst.

D.

Hunger.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Hyperglycemia in gestational diabetes typically leads to increased urination, or polyuria, not decreased urination. Elevated blood glucose levels overwhelm the renal tubules' reabsorption capacity, leading to glucose spilling into the urine, which then draws water osmotically, increasing urine output.

Choice B rationale

Shallow respirations are not a direct manifestation of hyperglycemia in this context. While severe diabetic ketoacidosis (DKA), a complication of uncontrolled diabetes, can lead to Kussmaul respirations (deep, rapid breathing) due to metabolic acidosis, hyperglycemia alone typically does not cause shallow respirations.

Choice C rationale

Thirst, or polydipsia, is a classic manifestation of hyperglycemia. High blood glucose levels increase the osmolality of the blood, stimulating osmoreceptors in the hypothalamus, which then trigger the sensation of thirst as the body attempts to dilute the excess glucose and restore fluid balance.

Choice D rationale

While hunger (polyphagia) is a common symptom in uncontrolled type 1 diabetes due to cellular inability to utilize glucose, in gestational diabetes with hyperglycemia, hunger is not a predominant or consistent symptom. The body typically has sufficient insulin, but there is insulin resistance or insufficient production.


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Related Questions

Correct Answer is B

Explanation

Choice A rationale:

At approximately 20 weeks of gestation, the fundus is typically located at the level of the umbilicus. By 32 weeks, the uterus has grown significantly beyond this point. Therefore, a fundal height at the umbilicus would be inconsistent with 32 weeks gestation and may suggest intrauterine growth restriction or incorrect dating if observed.

Choice B rationale:

At 32 weeks of gestation, the fundus is expected to be located about halfway between the umbilicus and the xiphoid process. Fundal height in centimeters generally correlates with gestational age between 20 and 36 weeks. Thus, a measurement of approximately 32 cm from the symphysis pubis to the top of the fundus is expected, placing it midway between these anatomical landmarks.

Choice C rationale:

The fundus typically reaches the xiphoid process around 36 to 40 weeks of gestation. At 32 weeks, it has not yet ascended to this level. A fundal height at the xiphoid process at 32 weeks may suggest polyhydramnios, macrosomia, or multiple gestation, and would require further evaluation.

Choice D rationale:

At 16 weeks of gestation, the fundus is generally located halfway between the symphysis pubis and the umbilicus. By 32 weeks, the uterus has expanded well beyond this point. A fundal height at this level would be abnormally low for 32 weeks and could indicate fetal growth restriction or oligohydramnios.

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"A,B"}}

Explanation

? Rationales for Each Condition

1️⃣ Neonatal abstinence syndrome (NAS)

Definition: NAS is a withdrawal syndrome in newborns caused by in utero exposure to opioids or other substances. It typically presents within 24–72 hours after birth.

Findings and Scientific Explanation:

  • Cry characteristics: A high-pitched, inconsolable cry is a hallmark of NAS due to autonomic nervous system dysregulation.
  • Nasal findings: Sneezing and nasal stuffiness are common due to increased autonomic activity and are not typically seen in hypoglycemia.
  • Tremor: Tremors, especially when undisturbed, are due to central nervous system irritability from opioid withdrawal.
  • Maternal urine drug screen: A positive result for opioids confirms in utero exposure, supporting a diagnosis of NAS.
  • Respiratory rate: Tachypnea (e.g., 65/min on Day 3) is common in NAS due to increased metabolic demand and autonomic instability. Normal neonatal respiratory rate is 30–60/min.

2️⃣ Hypoglycemia

Definition: Neonatal hypoglycemia is defined as a plasma glucose concentration less than 40–45 mg/dL in the first 24 hours of life.

Findings and Scientific Explanation:

  • Cry characteristics: Hypoglycemia may cause irritability or weak cry due to neuroglycopenia.
  • Tremor: Tremors or jitteriness can result from adrenergic stimulation in response to low glucose levels.
  • Respiratory rate: Tachypnea may occur as a compensatory response to metabolic acidosis secondary to hypoglycemia. The newborn had a glucose of 35 mg/dL on Day 1, which is below the normal range (>40–45 mg/dL).

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