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A nurse is caring for a client who is pregnant.

Medical History 1100:

Gravida 4 Para 3

32 weeks of gestation BMI 32
History of two newborns weighing over 4.5 kg (10 lb) Family history of type one diabetes mellitus (maternal) Fetal heart tones 140/min via doppler
Which of the following provider prescriptions should the nurse plan to implement? Select the 3 actions the nurse should plan to take.

A.

Encourage the client to limit carbohydrate intake to 40% of their daily calories.

B.

Instruct the client to check a random blood glucose level once daily.

C.

Anticipate a prescription for metformin.

D.

Conduct a non-stress test twice per week.

Answer and Explanation

Correct Answer : A,C,D

A.The client should limit carbohydrate intake to reduce the risk of gestational diabetes and its complications both in the mother and the fetus.
Glucose monitoring should be done 4 times daily.

C.    Metformin is commonly prescribed to manage glucose levels in pregnant individuals with GDM.
D.    The client's history of macrosomic newborns and family history of type 1 diabetes mellitus indicate an increased risk for complications such as fetal macrosomia and fetal distress. Nonstress tests are used to assess fetal well-being by monitoring fetal heart rate patterns.
E.    With a BMI of 32 and a history of macrosomic newborns, the client is at an increased risk for developing gestational diabetes mellitus (GDM). Regular exercise is important in managing blood glucose levels and reducing the risk of GDM.
 


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Related Questions

Correct Answer is ["B","D","F"]

Explanation

Correct Choices for Indicating Understanding:

  • "I should make sure that my baby feeds 8 to 12 times per day."
  • "My baby's stools should turn to a yellow color within the next day or two."
  • "I should expect my breasts to become harder, warmer, and more tender when my milk comes in."

Rationale

  • "Because of my baby's weight loss, I need to supplement with formula after breastfeeding."

    • This statement does not necessarily indicate an understanding of discharge teaching, as supplementation should only be done based on medical advice and not solely based on perceived weight loss.

  • "I should make sure that my baby feeds 8 to 12 times per day."

    • This statement indicates an understanding of discharge teaching, as frequent feeding is important for newborns to ensure adequate nutrition and hydration, and to promote milk production in breastfeeding mothers.

  • "I should cover my sore nipples with plastic-lined breast pads after every feeding."

    • This statement does not indicate proper understanding, as plastic-lined breast pads can retain moisture and increase the risk of infection. Instead, breathable pads or natural remedies are often recommended.

  • "My baby's stools should turn to a yellow color within the next day or two."

    • This statement indicates an understanding of normal neonatal stool changes, as breastfed babies' stools typically transition to a yellow color within a few days of birth.

  • "I can increase my milk supply by drinking more water."

    • While staying hydrated is important, this statement alone is insufficient for indicating a comprehensive understanding of increasing milk supply. Effective breastfeeding practices and frequent nursing are more directly impactful.

  • "I should expect my breasts to become harder, warmer, and more tender when my milk comes in."

    • This statement indicates an understanding of the common experience of breast engorgement when milk comes in, which is a normal part of the breastfeeding process.

Correct Answer is D

No explanation

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