A nurse is reviewing the medical record of a client who is receiving treatment for gestational diabetes mellitus. Which of the following medications should the nurse expect to administer?

Levothyroxine

Glyburide

C. Nifedipine

Chlorpromazine

Answer and Explanation

The Correct Answer is B

Glyburide is an oral hypoglycemic medication used to control blood glucose levels in individuals with type 2 diabetes. It is also used in the management of gestational diabetes mellitus (GDM) when dietary and lifestyle interventions alone are not sufficient to control blood glucose levels. Glyburide works by stimulating the pancreas to release insulin and also by increasing the sensitivity of peripheral tissues to insulin. It is preferred over insulin injections because it is easier to administer and monitor, and it does not pose a risk of hypoglycemia as long as blood glucose levels are closely monitored. In addition, glyburide does not cross the placenta, which minimizes the risk of fetal hypoglycemia. However, some studies have suggested that glyburide may be associated with an increased risk of neonatal hypoglycemia and macrosomia (large birth weight), so careful monitoring of the mother and fetus is required. Other medications such as levothyroxine, nifedipine, and chlorpromazine are not used in the management of gestational diabetes mellitus.

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Correct Answer is C

Explanation

A.This would be appropriate if the fetus were in a breech presentation.

B.This is incorrect because the fetal back is in the lower left quadrant, not the upper quadrant.

C.In the Left Occipitoanterior (LOA) Position, the fetal occiput (back of the head) is facing the mother’s left side and anteriorly (toward the front of the uterus). The fetal back will be on the left side of the maternal abdomen, making the PMI in the left lower quadrant. The best location to place the fetal monitor is over the fetal back, closest to the head. Since the fetus is cephalic (head down) in LOA position, the heart sounds are heard in the left lower quadrant.

D.This would be appropriate if the fetus were in a right occipitoanterior (ROA) position, but in LOA, the back is on the left.

A. Keep the newborn supine throughout treatment. B. Dress the newborn in lightweight clothing. C. Measure the newborn's temperature every 8 hr. D. Avoid using lotion or ointment on the newborn's skin.

Correct Answer is D

Explanation

A. It is essential to regularly reposition the newborn (every 2-3 hours) to ensure even exposure to the phototherapy light and to prevent pressure sores. Keeping the newborn supine throughout the treatment is not recommended.

B. The newborn should be undressed, except for a diaper, during phototherapy to maximize skin exposure to the light. Lightweight clothing can reduce the effectiveness of the treatment.

C. Temperature monitoring should be more frequent than every 8 hours. Phototherapy can cause fluctuations in the newborn's temperature, including overheating or hypothermia, so checking every 2-4 hours is generally recommended.

D. Lotions or ointments should not be applied to the newborn's skin during phototherapy because they can absorb heat, potentially leading to burns or skin irritation. Phototherapy can dry out the skin, but moisturizing treatments should be avoided during the therapy itself.

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A nurse is reviewing the medical record of a client who is receiving treatment for gestational diabetes mellitus. Which of the following medications should the nurse expect to administer?

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who is at 39 weeks of gestation and determines that the fetus is in a left occipitoanterior position. On which of the following sites should the nurse place the external fetal monitor to hear the point of maximum impulse of the fetal heart rate?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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