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) "What are you looking forward to each day?": While asking about daily expectations can provide insight into the client's coping mechanisms and hopefulness, it does not immediately address potential safety concerns. It is a helpful question for assessing the client's adjustment but not the priority if there is a concern about suicidal ideation.

B) "Can you tell me about your sleep patterns?": Sleep patterns are important for understanding overall well-being, especially during grief. However, this question is secondary to addressing the immediate risk of self-harm. Assessing sleep can come after determining if the client is having suicidal thoughts.

C) "Have you ever felt like you don't want to live anymore?": This question is crucial because it directly assesses the client's risk of suicidal ideation or self-harm. Given the client's recent loss and current symptoms, it is important to evaluate if there is a risk to their safety, making this the priority question.

D) "Are you taking any medications at this time?": While it is important to know about the client's medication use, this question does not address the immediate risk of self-harm or assess the psychological impact of the recent loss. Medication information is less urgent compared to evaluating suicidal thoughts.

A. "Limit crossing your legs at your knees to 30 minutes at a time." B. "Elevate the head of the bed when sleeping at night." C. "Wash your graduated compression stockings in the washing machine." D. "Put on your graduated compression stockings before getting out of bed."

Correct Answer is D

Explanation

A) Limit crossing your legs at your knees to 30 minutes at a time: Crossing the legs at the knees can restrict blood flow and increase venous pressure, which is detrimental to clients with venous insufficiency. It's generally advised to avoid crossing legs altogether rather than limiting it to 30 minutes.

B) Elevate the head of the bed when sleeping at night: Elevating the head of the bed does not significantly aid in improving venous return from the legs. Elevating the legs instead helps reduce venous pressure and promotes better circulation, which is more beneficial for venous insufficiency.

C) Wash your graduated compression stockings in the washing machine: Washing compression stockings in a washing machine can damage their elasticity and effectiveness. It's better to hand wash them and let them air dry to maintain their compression properties.

D) Put on your graduated compression stockings before getting out of bed: Putting on compression stockings before getting out of bed helps to prevent blood from pooling in the legs. This maximizes their effectiveness in reducing edema and promoting venous return throughout the day.

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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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