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 A

Explanation

A) Measure the client's manifestations using an anxiety rating scale: This action is essential as the first step because it allows the nurse to accurately assess the severity of the client's anxiety. Understanding the level of anxiety helps in planning appropriate interventions and monitoring the effectiveness of any treatment provided. Accurate assessment is foundational in clinical decision making.

B) Initiate a referral to a local support group: While beneficial, referring the client to a support group should follow an initial assessment. Support groups can offer long-term benefits, but immediate needs and severity must be evaluated first.

C) Assist in finding alternative ways to cope: Helping the client develop coping strategies is an important intervention. However, before suggesting specific coping mechanisms, the nurse needs to understand the current level of anxiety and how it affects the client. This ensures that the coping strategies are appropriately tailored.

D) Administer an antianxiety medication: Administering medication can be crucial in managing severe anxiety, but this step should come after a thorough assessment. The nurse needs to determine if medication is necessary and what dosage might be appropriate, based on the anxiety rating scale and other assessment findings.

A. Manic behavior B. Deep, labored respirations C. Bradycardia D. Cold intolerance

Correct Answer is A

Explanation

A) Manic behavior: Hyperthyroidism can lead to manic or hyperactive behavior due to increased metabolic rate and overstimulation of the nervous system. This may present as irritability, anxiety, or restlessness, making manic behavior a relevant manifestation in this condition.

B) Deep, labored respirations: Hyperthyroidism generally does not cause deep, labored respirations. Instead, it may lead to increased respiratory rate due to heightened metabolic activity. Deep, labored respirations are more indicative of respiratory or cardiac issues rather than hyperthyroidism.

C) Bradycardia: Hyperthyroidism usually causes tachycardia (elevated heart rate) rather than bradycardia (slow heart rate). Tachycardia is a common symptom due to the increased metabolic rate and sympathetic nervous system activity associated with hyperthyroidism.

D) Cold intolerance: Cold intolerance is more characteristic of hypothyroidism, where there is decreased metabolic activity and reduced heat production. Hyperthyroidism typically causes heat intolerance due to the increased metabolic rate and elevated body temperature.

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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

Naxlex Comprehensive Predictor Exams

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