Gestational Diabetes > Maternal & Newborn
Exam Review
Complications
Total Questions : 5
Showing 5 questions, Sign in for moreA nurse is providing education to a pregnant client with gestational diabetes.
The nurse explains that if the baby develops low blood sugar after birth due to excess insulin production, it can lead to which of the following complications if left untreated?
Explanation
The correct answer is choice B. Jaundice.
Jaundice is a condition where the skin and whites of the eyes turn yellow due to excess bilirubin in the blood.
Bilirubin is a byproduct of red blood cell breakdown.If the baby develops low blood sugar after birth due to excess insulin production, it can lead to increased red blood cell breakdown and jaundice.
Choice A is wrong because respiratory distress syndrome (RDS) is a condition where the baby has difficulty breathing due to immature lungs and lack of surfactant.RDS is more common in preterm babies and babies of diabetic mothers, but it is not caused by low blood sugar.
Choice C is wrong because preterm birth is a birth that occurs before 37 weeks of gestation.Preterm birth can be caused by many factors, such as infection, placental abruption, or multiple gestation, but it is not a complication of low blood sugar after birth.
Choice D is wrong because preeclampsia is a condition where the mother develops high blood pressure and proteinuria after 20 weeks of gestation.Preeclampsia can affect the placenta and the baby’s growth, but it is not a complication of low blood sugar after birth.
Normal ranges for blood sugar in newborns are 40 to 80 mg/dL (2.2 to 4.4 mmol/L).Normal ranges for bilirubin in newborns are 1 to 12 mg/dL (17 to 205 µmol/L).
A client with gestational diabetes asks the nurse about the risk of the baby growing larger than usual.
The nurse explains that this condition is known as macrosomia and it can result in which of the following difficulties during delivery?
Explanation
The correct answer is
B. Need for induced labor or cesarean section.
Gestational diabetes mellitus (GDM) is a condition where the mother has high blood sugar levels during pregnancy.
This can affect the growth and development of the baby.
One of the possible complications of GDM is fetal macrosomia, which means the baby is larger than normal for its gestational age.Macrosomia is usually defined as a birth weight above 4000 to 4500 grams (or 9 to 10 pounds).
Macrosomia can cause difficulties during delivery, such as shoulder dystocia, which is when the baby’s shoulder gets stuck behind the mother’s pelvic bone.This can lead to injuries to the baby’s nerves, bones, or muscles, or to the mother’s vagina, uterus, or bladder.To prevent these complications, doctors may recommend inducing labor or performing a cesarean section (C-section) to deliver the baby safely.
The other statements are wrong because:
A. Increased risk of jaundice.
Jaundice is a condition where the baby’s skin and eyes turn yellow due to high levels of bilirubin in the blood.
Bilirubin is a waste product that is normally removed by the liver.Jaundice can occur in any newborn, but it is more common in babies with GDM because they may have polycythemia (too many red blood cells) or hypoglycemia (low blood sugar levels) that can affect the liver function.
However, jaundice is not directly related to macrosomia and does not cause difficulties during delivery.
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C. Development of preeclampsia.
Preeclampsia is a serious condition where the mother develops high blood pressure and protein in the urine after 20 weeks of pregnancy.
Preeclampsia can cause complications such as seizures, stroke, organ damage, or placental abruption (when the placenta separates from the uterus before delivery).Preeclampsia can increase the risk of fetal growth restriction (when the baby does not grow well in the womb), not macrosomia.
Preeclampsia can also cause difficulties during delivery, but it is not a result of macrosomia.
D. Higher risk of stillbirth.
Stillbirth is when the baby dies in the womb after 20 weeks of pregnancy.
Stillbirth can occur due to various causes, such as infections, genetic abnormalities, placental problems, or umbilical cord accidents.Stillbirth can also occur in babies with GDM because they may have hypoxia (low oxygen levels) or acidosis (high acid levels) in the blood due to poor placental function or uncontrolled blood sugar levels.
However, stillbirth is not directly related to macrosomia and does not cause difficulties during delivery.
A nurse is assessing a newborn for signs of hypoglycemia.
Which of the following blood glucose levels, taken 1 to 2 hours after birth, would indicate hypoglycemia in the newborn?
Explanation
The correct answer is choice D. 20 mg/dL.This is because a blood glucose level below 40 mg/dL is considered hypoglycemia in a newborn.Hypoglycemia can cause neurological damage and other complications in newborns.
Choice A.40 mg/dL is wrong because this is the lower limit of normal blood glucose level for a newborn.
Choice B.35 mg/dL is wrong because this is slightly below the normal range but not low enough to be hypoglycemic.
Choice C.30 mg/dL is wrong because this is also below the normal range but not as low as choice D. Normal blood glucose levels for newborns are between 40 and 150 mg/dL, depending on the time of measurement and the feeding status.Blood glucose levels are usually lowest 1 to 2 hours after birth and then gradually increase over the next few days.
A client with gestational diabetes asks the nurse about the risk of developing type 2 diabetes later in life.
The nurse explains that both the mother and the baby have an increased risk.
This is primarily due to:.
Explanation
The correct answer is choice D. Genetic factors.This is because having gestational diabetes increases the risk of developing type 2 diabetes later in life for both the mother and the baby, and this risk is influenced by genetic factors.
Some possible explanations for the other choices are:
• Choice A is wrong because the baby’s excessive insulin production is a result of high blood sugar levels in the mother, not a cause of gestational diabetes.
• Choice B is wrong because poor placental function is not a primary cause of gestational diabetes, although it may be affected by high blood sugar levels in the mother.
• Choice C is wrong because uncontrolled blood sugar levels during pregnancy are a consequence of gestational diabetes, not a primary cause of it.
A nurse is providing education to a pregnant client with gestational diabetes about the risk of preeclampsia.
The nurse explains that preeclampsia can lead to which of the following complications if left untreated?
Explanation
The correct answer is choice B. Increased risk of stillbirth.Preeclampsia is a condition that develops in pregnant women, marked by high blood pressure and presence of proteins in urine that indicate kidney damage.If left untreated, preeclampsia can lead to serious complications for both the mother and the baby.
Choice A is wrong because low blood sugar in the baby is not a direct complication of preeclampsia.Low blood sugar can occur in babies whose mothers have diabetes, but it can be prevented by proper management of blood glucose levels during pregnancy.
Choice C is wrong because brain damage due to jaundice is not a direct complication of preeclampsia.
Jaundice is a condition where the baby’s skin and eyes turn yellow due to high levels of bilirubin, a waste product of red blood cells.Jaundice can occur in babies whose mothers have liver problems, but it can be treated by phototherapy or blood transfusion.
Choice D is wrong because respiratory distress syndrome in the baby is not a direct complication of preeclampsia.
Respiratory distress syndrome is a condition where the baby’s lungs are not fully developed and cannot provide enough oxygen to the body.Respiratory distress syndrome can occur in premature babies, but it can be prevented by giving corticosteroids to the mother before delivery to help mature the baby’s lungs.
Normal ranges for blood pressure are 120/80 mmHg or lower for systolic (top number) and diastolic (bottom number) respectively.Normal ranges for protein in urine are less than 150 mg per day or less than 30 mg per liter.
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