A nurse is teaching a newly licensed nurse about the uses of ultrasonography in the first trimester of pregnancy. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

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.

Three uterine contractions within a 20-min period require intervention by the nurse during a nonstress test at 35 weeks of gestation. The nonstress test is used to assess fetal well-being by monitoring the fetal heart rate (FHR) response to fetal movement. The test is considered reactive if there are two or more accelerations of the FHR within a 20-min period, each lasting at least 15 seconds and peaking at least 15 beats above the baseline. In this scenario, the finding that requires intervention by the nurse is three uterine contractions within a 20-min period. This is because frequent or prolonged contractions can indicate preterm labor, which requires immediate intervention

to prevent premature delivery. The nurse should assess the client for signs and symptoms of preterm labor, such as pelvic pressure, low back pain, vaginal bleeding or discharge, and abdominal cramping. The nurse should also notify the provider and prepare the client for further evaluation and possible interventions, such as tocolytic therapy to stop the contractions.