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 C
Explanation
A firm, displaced fundus to the right of midline indicates a full bladder. A distended bladder can prevent the uterus from contracting properly and can lead to uterine atony, increasing the risk of postpartum hemorrhage. Therefore, the priority action is to have the client empty her bladder.
This can often be achieved by encouraging the client to urinate or by assisting her with toileting if necessary. Palpating a fundus that is firm and displaced does not indicate the need for fundal massage, as the fundus is already firm. Inserting a urinary catheter may be necessary if the client is unable to void spontaneously, but this should be done after attempting to have the client
urinate voluntarily. Administering an analgesic is not indicated based on the information provided.
Correct Answer is A
Explanation
Painless vaginal bleeding in the third trimester could be a sign of placenta previa or placental abruption, both of which are serious conditions requiring immediate medical attention. This client should be seen first due to the potential urgency of the situation.
B. Vaginal spotting in early pregnancy may indicate implantation bleeding or other benign causes, but it could also be a sign of threatened miscarriage or ectopic pregnancy. While this client needs assessment, it's not as urgent as antepartum hemorrhage.
C. A client who is at 14 weeks of gestation and reports nausea and vomiting:
Nausea and vomiting are common symptoms in early pregnancy and typically do not require urgent intervention unless severe dehydration or hyperemesis gravidarum is present.
D. A cough and fever in late pregnancy may indicate a respiratory infection or another illness, but it does not pose an immediate threat to maternal or fetal health.
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