A nurse is educating a pregnant woman with gestational diabetes about physical activity.

Which statement by the client indicates understanding?

The correct answer is choice A.“I should have the oral glucose tolerance test between 24 and 28 weeks of gestation.” This statement indicates understanding because it reflects the current recommendation for gestational diabetes screening for all pregnant women.The oral glucose tolerance test (OGTT) measures how the body handles glucose after a glucose load and can detect impaired glucose tolerance or diabetes.

Choice B is wrong because the woman does not need to eat a high-carbohydrate meal before the screening test.In fact, she should fast for at least 8 hours before the test.

Choice C is wrong because the screening process is necessary even if the woman has no family history of diabetes.Gestational diabetes can occur in any pregnant woman, especially if she has risk factors such as obesity, advanced maternal age, previous history of gestational diabetes, or a history of polycystic ovary syndrome.

Choice D is wrong because the screening test should not be done at any time during the pregnancy.The optimal time for screening is between 24 and 28 weeks of gestation, when insulin resistance peaks due to placental hormones.If the test is done too early or too late, it may miss some cases of gestational diabetes or give false-positive results.

The correct answer is choice A. Insulin administration may be necessary if dietary modifications and physical activity alone are insufficient.

This is because gestational diabetes mellitus (GDM) is a condition that affects the way the body uses glucose during pregnancy, and it can cause high blood sugar levels that can affect the health of both the mother and the baby.Insulin is a hormone that helps the body use glucose for energy, and some women with GDM may need to take insulin injections to keep their blood sugar levels within normal range.

Choice B is wrong because skipping insulin doses can lead to dangerously high blood sugar levels that can cause complications such as ketoacidosis, fetal distress, preterm labor, or stillbirth.

Women with GDM should follow their prescribed insulin regimen and monitor their blood sugar levels regularly.

Choice C is wrong because insulin therapy is not the first-line treatment for GDM.The first-line treatment for GDM is lifestyle changes such as eating a balanced diet, limiting carbohydrates and sweets, increasing fiber intake, and exercising moderately for at least 30 minutes a day.

These measures can help lower blood sugar levels and reduce the need for insulin therapy.

However, if lifestyle changes are not enough to control blood sugar levels, insulin therapy may be added as a second-line treatment.

Choice D is wrong because insulin cannot be administered at any time during the day.

Insulin therapy for GDM requires careful timing and dosing to match the blood sugar patterns and needs of each woman.Insulin therapy for GDM usually involves a combination of short-acting and intermediate-acting insulin that are given before meals and at bedtime.

The timing and dosage of insulin depend on factors such as the woman’s weight, blood sugar levels, diet, activity level, and fetal growth.

Women with GDM should consult their health care provider or diabetes educator about their individualized insulin regimen.