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 D

Explanation

A) Drowsiness: While drowsiness can be a symptom of elevated magnesium levels, it is not the most critical finding to report immediately. Drowsiness can be observed with other conditions as well.

B) Diminished patellar reflexes: This can be indicative of hypermagnesemia, but it is a less immediate concern compared to other symptoms. Monitoring reflexes is important, but not the priority.

C) Generalized muscle weakness: Muscle weakness is a common symptom of elevated magnesium levels, but it is less urgent compared to cardiac issues. Although important, it does not pose an immediate risk like bradycardia.

D) Bradycardia: Elevated magnesium levels can cause serious cardiac complications, including bradycardia. This can be life-threatening and requires prompt attention to prevent severe outcomes, making it the priority to report to the provider.

A. Staying current on scheduled immunizations B. Maternal smoking during pregnancy C. Newborn who is large for gestational age D. Meconium staining of amniotic fluid

Correct Answer is B

Explanation

A) Staying current on scheduled immunizations: Staying up-to-date with immunizations is important for overall child health but is not a direct risk factor for sudden infant death syndrome (SIDS). Immunizations can help prevent infections that could contribute to SIDS but are not directly related to the syndrome itself.

B) Maternal smoking during pregnancy: Maternal smoking during pregnancy is a well-documented risk factor for SIDS. Exposure to nicotine and other harmful substances from smoking can affect the baby's respiratory system and increase the likelihood of SIDS.

C) Newborn who is large for gestational age: Being large for gestational age is not a recognized risk factor for SIDS. SIDS risk factors are more closely associated with prenatal and postnatal conditions, rather than birth weight alone.

D) Meconium staining of amniotic fluid: Meconium staining of amniotic fluid is a condition that can indicate fetal distress during labor but is not a direct risk factor for SIDS. It is more related to potential complications during delivery rather than SIDS risk.

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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?

Nursing Test Bank

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