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.
Encourage the client to limit carbohydrate intake to 40% of their daily calories.
Instruct the client to check a random blood glucose level once daily.
Anticipate a prescription for metformin.
Conduct a non-stress test twice per week.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Small for gestational age (SGA) newborns are at risk of hypoglycemia due to decreased glycogen stores and limited fat reserves. Therefore, monitoring blood glucose levels is essential to detect and promptly intervene in case of hypoglycemia.
A, B, C- monitoring other parameters such as vital signs, axillary temperature and weight are important aspects of newborn care but not specific to SGA newborns.
Correct Answer is C
Explanation
Insulin is the most commonly used medication for managing gestational diabetes because it does not cross the placenta and is considered safe for both the mother and the fetus. Other oral antidiabetic medications like repaglinide, glipizide, and acarbose are generally not recommended during pregnancy due to concerns about their safety for the fetus.
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