A nurse is teaching a client who has pregestational type 1 diabetes mellitus about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

"I should have a goal of maintaining my fasting blood glucose between 100 and 120."

"I should engage in moderate exercise for 30 minutes if my blood glucose is 250 or greater."

"I will continue taking my insulin if I experience nausea and vomiting

"I will ensure that my bedtime snack is high in refined sugar."

Answer and Explanation

The Correct Answer is C

Choice A Reason:

"I should have a goal of maintaining my fasting blood glucose between 100 and 120." This statement does not indicate understanding of the teaching. Recommended target for fasting blood glucose levels during pregnancy in women with diabetes is typically lower, often between 60 and 90 mg/dL.

Choice B Reason:

"I should engage in moderate exercise for 30 minutes if my blood glucose is 250 or greater." This statement does not indicate understanding of the teaching . Exercising when blood glucose is already elevated to 250 or greater may not be safe. Exercise is generally recommended to help manage blood glucose levels, but the specific approach and timing should be discussed with the healthcare provider.

Choice C Reason:

"I will continue taking my insulin if I experience nausea and vomiting." This statement reflects an awareness of the importance of continuing insulin administration even if the client is experiencing nausea and vomiting. Consistent insulin management is crucial for maintaining blood glucose levels within the target range during pregnancy.

Choice D Reason:

"I will ensure that my bedtime snack is high in refined sugar." This statement does not indicate understanding of the teaching. Bedtime snacks should focus on providing sustained energy and stabilizing blood glucose levels. A snack high in refined sugar is not recommended as it can lead to fluctuations in blood glucose levels.

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Correct Answer is A

Explanation

Choice A Reason:

Bilirubin 9 mg/dL is correct. A bilirubin level of 9 mg/dL in a newborn, especially at 4 hours old, is elevated and needs prompt attention. High bilirubin levels in newborns can be indicative of jaundice, and severe jaundice may lead to complications such as kernicterus. Monitoring and managing bilirubin levels are crucial to prevent potential neurologic damage.

Choice B Reason:

Hemoglobin 15 g/dL is incorrect. This hemoglobin level is within the normal range for a newborn. It's important to note that newborns often have higher hemoglobin levels shortly after birth, and this value is consistent with normal physiological ranges.

Choice C Reason:

Platelets 175,000/mm³ is incorrect. A platelet count of 175,000/mm³ is within the normal range for a newborn. There is no immediate concern based on this platelet count.

Choice D Reason:

Hematocrit 45% is incorrect. A hematocrit level of 45% is within the normal range for a newborn. Like hemoglobin, hematocrit levels can be higher in newborns shortly after birth, and this value falls within the expected range.

A. Percutaneous umbilical blood sampling B. Amnioinfusion C. Biophysical profile (BPP) D. Chorionic villus sampling (CVS)

Correct Answer is C

Explanation

Choice A Reason:

Percutaneous umbilical blood sampling (PUBS) is not appropriate. This invasive procedure involves sampling blood from the umbilical cord and is not typically used in the context of a positive contraction stress test.

Choice B Reason:

Amnioinfusion is not appropriate. Amnioinfusion is a procedure in which sterile fluid is infused into the amniotic cavity to alleviate conditions such as oligohydramnios. It is not a primary diagnostic test for assessing fetal well-being.

Choice C Reason:

Biophysical profile (BPP) is appropriate. The biophysical profile is a diagnostic test that assesses the well-being of the fetus by evaluating various parameters, including fetal heart rate, fetal breathing movements, fetal movements, fetal tone, and the amniotic fluid volume. This test provides additional information to assess fetal well-being and can help guide decisions about the timing and mode of delivery.

Choice D Reason:

Chorionic villus sampling (CVS) is inappropriate. CVS is a prenatal test used for diagnosing certain genetic conditions but is not indicated in the context of a positive contraction stress test.

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A nurse is teaching a client who has pregestational type 1 diabetes mellitus about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

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