A nurse is reinforcing teaching with a client who is in her second trimester and has a new diagnosis of gestational diabetes. Which of the following statements by the client indicates a need for further teaching?

"I should limit my carbohydrates to 50% of my daily caloric intake."

"I know I am at increased risk to develop type 2 diabetes."

"I will reduce my exercise schedule to 3 days a week."

"I will take my glyburide daily with breakfast."

Answer and Explanation

The Correct Answer is C

c. "I will reduce my exercise schedule to 3 days a week."

The client should not reduce her exercise schedule, as physical activity can help lower blood glucose levels and improve insulin sensitivity in gestational diabetes. The client should aim for at least 30 minutes of moderate-intensity exercise on most days of the week unless contraindicated by her provider. Exercise can also help prevent excessive weight gain, preeclampsia, and macrosomia in pregnancy.

The other statements are correct and do not indicate a need for further teaching.

The client should limit her carbohydrates to 50% of her daily caloric intake, as carbohydrates have the most impact on blood glucose levels. The client should also choose complex carbohydrates that are high in fiber and low in glycemic index, such as whole grains, fruits, and vegetables. The client should know that she is at increased risk of developing type 2 diabetes, as gestational diabetes is a risk factor for future diabetes mellitus. The client should undergo screening for diabetes 6 to 12 weeks after delivery and every 1 to 3 years thereafter. The client should also adopt lifestyle modifications such as a healthy diet, regular exercise, and weight management to prevent or delay the onset of type 2 diabetes. The client should take her glyburide daily with breakfast, as glyburide is an oral antidiabetic agent that can be used to treat gestational diabetes when diet and exercise are not enough to control blood glucose levels. Glyburide stimulates the pancreas to produce more insulin and lowers blood glucose levels. Glyburide should be taken with the first meal of the day to avoid hypoglycemia.

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Correct Answer is D

No explanation

A. Observe for pooling of blood under the butocks. B. Assess client's blood pressure. C. Prepare to administer a prescribed oxytocic preparation. D. Massage the client's fundus.

Correct Answer is D

Explanation

The nurse's first action should be to massage the client's fundus, as this can help stimulate uterine contraction and prevent hemorrhage. The fundus is the upper part of the uterus that contracts and involutes after delivery to compress the blood vessels and stop bleeding. The nurse should palpate the fundus for firmness, height, and position, and massage it gently if it is boggy or displaced.

The other actions are not the first priority and may be done after massaging the fundus.

The nurse should observe for the pooling of blood under the buttocks, as this can indicate a large amount of blood loss that may not be visible on the perineal pad. However, this is not the first action to take, as it does not address the cause of the bleeding or stop it from continuing.

The nurse should assess the client's blood pressure, as this can indicate the severity of blood loss and the presence of shock. However, blood pressure may not change significantly until a large amount of blood is lost, and it is not specific to the cause of bleeding. Therefore, blood pressure is not the first action to take.

The nurse should prepare to administer a prescribed oxytocic preparation, such as oxytocin or methylergonovine, as this can enhance uterine contraction and reduce bleeding. However, this requires a provider's order and may take time to obtain and administer. Therefore, an oxytocic preparation is not the first action to take.

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A nurse is reinforcing teaching with a client who is in her second trimester and has a new diagnosis of gestational diabetes. Which of the following statements by the client indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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