The practical nurse (PN) is caring for a client who has been diagnosed with gestational diabetes mellitus. Which complication should the PN recognize as the greatest risk to the fetus if euglycemia is not maintained?
Low birth weight.
Preterm birth.
Cleft palate.
Macrosomic newborn.
The Correct Answer is D
Gestational diabetes mellitus (GDM) is a type of diabetes that occurs during pregnancy. If euglycemia, or normal blood glucose levels, is not maintained during pregnancy, the fetus can be at risk for a number of complications. The greatest risk to the fetus in this situation is the development of a macrosomic newborn, or a newborn that is significantly larger than average. This occurs because the excess glucose in the mother's bloodstream is passed on to the fetus, leading to excessive fetal growth.
Macrosomia can lead to complications during delivery, such as shoulder dystocia, and can increase the risk of injury to both the mother and the baby. While low birth weight and preterm birth are also potential complications of GDM, macrosomia is considered the greatest risk to the fetus if euglycemia is not maintained. Cleft palate is not typically associated with GDM.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The PN should report the injury details to the charge nurse. This is important because the charge nurse needs to be aware of any changes in the patient's condition and can help determine the appropriate course of action. The other options are not the most appropriate actions for the PN to take in this situation.
Obtaining a heel stick glucose (A) may be necessary if hypoglycemia is suspected, but it is not the most immediate concern.
Initiating strict intake and output measurements (C) may be necessary for monitoring fluid balance, but it is not the most immediate concern.
Swaddling the infant in a blanket (D) may provide comfort, but it does not address the underlying issue of the head injury and seizure episode.
Correct Answer is B
Explanation
The practical nurse (PN) should recognize that a newborn whose mother has poorly controlled type 1 diabetes mellitus and is exhibiting grunting with mild sternal retractions is exhibiting signs of patent ductus arteriosus. Patent ductus arteriosus is a condition in which the ductus arteriosus, a blood vessel that connects the pulmonary artery to the aorta, fails to close after birth. This can result in abnormal blood flow between the aorta and pulmonary artery, leading to respiratory distress.
Hypothyroidism (Option A) and hyperinsulinemia (Option C) are conditions that can occur in newborns, but they do not typically present with grunting and sternal retractions.
Ventral septal defect (Option D) is a congenital heart defect that can cause respiratory distress, but it is not specifically associated with maternal diabetes.
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