A nurse is teaching a pregnant woman with gestational diabetes about blood glucose monitoring.

Which instruction should the nurse provide?

The correct answer is choice A. “Perform self-monitoring of blood glucose using a glucometer.” This instruction will help the pregnant woman with gestational diabetes to monitor her blood glucose levels and adjust her insulin dosage accordingly.Self-monitoring of blood glucose is recommended at least four times a day for women with gestational diabetes.

Choice B is wrong because “Check blood glucose levels once a week.” is not frequent enough to ensure adequate glycemic control.Women with gestational diabetes need to check their blood glucose levels daily or more often.

Choice C is wrong because “Maintaining blood glucose levels within the recommended range is not necessary.” is false and dangerous.Maintaining blood glucose levels within the recommended range is essential to prevent maternal and fetal complications such as macrosomia, hypoglycemia, congenital anomalies, and preeclampsia.

Choice D is wrong because “Ignore symptoms of hypoglycemia and hyperglycemia.” is also false and dangerous.

Symptoms of hypoglycemia and hyperglycemia should not be ignored, but reported to the health care provider and treated promptly.

Hypoglycemia can cause maternal seizures, coma, and death.Hyperglycemia can cause fetal distress, stillbirth, and neonatal death.

The normal range for fasting blood glucose in pregnancy is 60 to 95 mg/dL.The normal range for postprandial blood glucose in pregnancy is 100 to 129 mg/dL.

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.