A nurse is educating a client who has gestational diabetes mellitus. Which of the following disease management strategies should the nurse include?

Consume 2,800 calories daily during the third trimester.

Distribute daily calories among three meals and three snacks.

Maintain a blood glucose level between 100 to 130 mg/dL before meals.

Restrict daily carbohydrate intake to 60% of total caloric intake.

Answer and Explanation

The Correct Answer is B

A. Consume 2,800 calories daily during the third trimester.: The caloric needs during pregnancy vary, but 2,800 calories might be excessive for someone with gestational diabetes. The focus should be on maintaining a balanced diet that helps control blood glucose levels rather than meeting a specific caloric target.

B. Distribute daily calories among three meals and three snacks.: Distributing calories throughout the day with balanced meals and snacks can help manage blood glucose levels and prevent significant spikes or drops. This approach is commonly recommended for managing gestational diabetes.

C. Maintain a blood glucose level between 100 to 130 mg/dL before meals.: The target for fasting blood glucose levels in gestational diabetes is generally less than 95 mg/dL. Maintaining blood glucose levels within this range is crucial to manage the condition effectively.

D. Restrict daily carbohydrate intake to 60% of total caloric intake.: Carbohydrate intake should be managed carefully, but it is not typically restricted to a specific percentage like 60%. Instead, a balanced approach with an emphasis on complex carbohydrates and monitoring individual responses is recommended.

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Correct Answer is C

Explanation

A) A school-age child who is 2 days postoperative following an appendectomy and has a nasogastric tube: While this child requires regular monitoring and care, they are in a stable postoperative phase and do not show signs of acute distress that necessitate immediate attention over other clients.

B) A preschooler awaiting discharge instructions prior to leaving the hospital: This client is stable enough to be considered for discharge. While discharge instructions are important, they do not take priority over a client with potential respiratory distress.

C) A toddler who has a respiratory rate of 54/min: This client exhibits a significantly elevated respiratory rate, which can indicate respiratory distress or a serious underlying condition. Immediate assessment and intervention are necessary to ensure the toddler's airway and breathing are managed appropriately.

D) A school-age child who reports nausea following chemotherapy: While nausea following chemotherapy is uncomfortable and needs management, it is a known side effect and typically not life-threatening. This client's condition is less urgent compared to a toddler showing signs of potential respiratory distress.

A. Wash hands for 10 seconds after caring for the client. B. Monitor the client for manifestations of dehydration. C. Use toilet paper to remove stool from the client's skin. D. Administer diphenoxylate/atropine to the client.

Correct Answer is B

Explanation

A) "Wash hands for 10 seconds after caring for the client.": Proper hand hygiene is critical in preventing the spread of infections, but the recommended duration for handwashing is at least 20 seconds. This option does not specify the necessary steps to ensure effective hand hygiene.

B) "Monitor the client for manifestations of dehydration.": Older adults are at a higher risk of dehydration due to gastroenteritis, which can cause significant fluid loss through vomiting and diarrhea. Monitoring for signs of dehydration, such as dry mucous membranes, decreased skin turgor, and reduced urine output, is a priority in managing their condition and preventing complications.

C) "Use toilet paper to remove stool from the client's skin.": While keeping the client clean is important, using toilet paper might not be sufficient or gentle enough to effectively clean and protect the skin. Using appropriate cleansing methods and skin care products is better for maintaining skin integrity.

D) "Administer diphenoxylate/atropine to the client.": While this medication can help reduce diarrhea, it may not be the first action to take. In some cases, stopping diarrhea too quickly can prevent the elimination of harmful pathogens. Monitoring and addressing hydration status is more critical initially in the management of gastroenteritis.

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A nurse is educating a client who has gestational diabetes mellitus. Which of the following disease management strategies should the nurse include?

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