For problems involving adult patients, the answer will be rounded to the nearest tenth. Although some IV pumps do not allow calibration to the tenth or hundredth, for the purpose of this exam, IV rate calculations will be rounded to the nearest whole drop (gt/min) or to the nearest whole number IV (ml/hr). To promote safety, a zero must be placed to the left of the decimal point in answers that are less than one. No zero is allowed to the right of the decimal point in answers that are whole numbers. For example, 0.5 mg must be answered as 0.5 mg and 5.0 mg must be answered as 5 mg.

The physician orders: Magnesium 4 gms loading dose to infuse over 30 minutes at 0500. Then infuse a maintenance dose of 1 gram /hr. The pharmacy sends 80 Gms in 1000 mL of LR. What would the nurse set the pump for the loading dose at 5 Am? Be sure to enter the number AND the unit of measurement (mL). Partial credit will not be given.

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.

G (Gravida) — Total number of pregnancies, including the current one.

Elective abortion at 9 weeks

Birth of twins at 36 weeks

Spontaneous abortion at 15 weeks

Current pregnancy at 28 weeks So, G = 4.

T (Term births) — Number of pregnancies carried to 37 weeks or beyond.

• • She hasn't had any pregnancies reach full term. So, T = 0.

P (Preterm births) — Number of pregnancies delivered between 20 and 36 weeks.

• • Twins born at 36 weeks. So, P = 1.

A (Abortions) — Number of pregnancies ending before 20 weeks (spontaneous or elective).

• • Elective abortion at 9 weeks
  • Spontaneous abortion at 15 weeks So, A = 2.

L (Living children) — Number of living children.

• • The twins are living children. So, L = 2.

Putting it all together, her GTPAL notation is G4 T0 P1 A2 L2.