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Gestational Diabetes
Study Questions
Introduction
A nurse is providing education to a pregnant woman diagnosed with gestational diabetes.
The nurse explains that gestational diabetes primarily affects ?
Explanation
The correct answer is choice B.Gestational diabetes primarily affects the baby’s growth and development.Gestational diabetes is a condition in which women develop high blood sugar during pregnancy due to hormonal changes or insufficient insulin production.This can cause the baby to grow larger than usual, which can lead to difficulties during delivery and increase the risk of cesarean section.It can also cause other complications for the baby, such as low blood sugar, jaundice, respiratory distress syndrome, and future diabetes.
Choice A is wrong because gestational diabetes does not affect blood pressure levels during pregnancy.However, high blood pressure during pregnancy can be a sign of another condition called preeclampsia, which can also cause complications for the mother and the baby.
Choice C is wrong because gestational diabetes does not affect the woman’s ability to produce insulin.
Rather, it affects how the cells use insulin to control blood sugar levels.The woman may need to take insulin injections or oral medications to manage her blood sugar levels during pregnancy.
Choice D is wrong because gestational diabetes does not affect the woman’s blood sugar levels after giving birth.
In most cases, gestational diabetes goes away after the baby is born.However, the woman may have a higher risk of developing type 2 diabetes later in life.
Normal ranges for blood sugar levels during pregnancy are:
• Before meals: 95 mg/dL or less
• One hour after meals: 140 mg/dL or less
• Two hours after meals: 120 mg/dL or less
A client with gestational diabetes asks the nurse about the timing of when gestational diabetes typically occurs.
The nurse responds by saying that it usually develops:.
Explanation
The correct answer is choice C.Gestational diabetes usually develops in thesecond or third trimester of pregnancy, when the body’s cells become more resistant to insulin due to hormonal changes.
Insulin is a hormone that helps the body use glucose (sugar) for energy.
Choice A is wrong because gestational diabetes does not develop in thefirst trimester of pregnancy.In fact, some women may have undiagnosed diabetes or pre-diabetes before they get pregnant, which can be detected by early screening.
Choice B is wrong because gestational diabetes does not developafter the baby is born.
For most women with gestational diabetes, the diabetes goes away soon after delivery.However, some women may have persistent diabetes or pre-diabetes that requires further testing and management.
Choice D is wrong because gestational diabetes does not developbefore pregnancy.Gestational diabetes is a type of diabetes that can develop during pregnancy in women who don’t already have diabetes.However, some women may have risk factors for developing gestational diabetes, such as being overweight, having a family history of diabetes, or having a previous history of GDM or macrosomia.
A nurse is discussing the long-term implications of gestational diabetes with a client.
The nurse explains that gestational diabetes increases the risk of developing which type of diabetes in the future?
Explanation
The correct answer is choice B. Type 2 diabetes.
Gestational diabetes is a condition that occurs when the body is not able to use insulin properly during pregnancy, which can cause high blood sugar levels.Gestational diabetes usually goes away after the baby is born, but it increases the risk of developing type 2 diabetes later in life.Type 2 diabetes is a chronic condition that affects how the body processes glucose, and it can be caused by genetic or lifestyle factors, such as obesity or physical inactivity.
Choice A is wrong because type 1 diabetes is an autoimmune disease that destroys the insulin-producing cells in the pancreas, and it is not related to gestational diabetes.
Choice C is wrong because gestational diabetes is not a type of diabetes, but a temporary condition that only affects pregnant women.
Choice D is wrong because prediabetes is a state of impaired glucose tolerance that can precede type 2 diabetes, but it is not a type of diabetes itself.Prediabetes can also be reversed with lifestyle changes, unlike type 2 diabetes.
A client with gestational diabetes is concerned about the impact of the condition on the baby's health.
The nurse reassures the client by explaining that gestational diabetes primarily affects the baby's:.
Explanation
The correct answer is choice D. Growth and development.
Gestational diabetes is a condition in which women develop high blood sugar during pregnancy.
This can affect the baby’s growth and development, as the excess glucose from the mother crosses the placenta and causes the baby to produce more insulin.This can lead to macrosomia, or a “fat” baby, which can cause complications during birth and increase the risk of obesity and diabetes later in life.
Choice A is wrong because gestational diabetes does not affect the baby’s vision.
Choice B is wrong because gestational diabetes does not affect the baby’s hearing.
Choice C is wrong because gestational diabetes does not affect the baby’s heart directly, although it can increase the risk of high blood pressure and preeclampsia in the mother.
A nurse is teaching a pregnant woman with gestational diabetes about lifestyle modifications.
Which statement by the client indicates an understanding of the teaching?
Explanation
The correct answer is choice C. Regular exercise can help control blood sugar levels.This is because exercise can improve insulin sensitivity and lower blood glucose levels.Exercise is an important part of lifestyle modifications for women with gestational diabetes, along with dietary changes.
Choice A is wrong because carbohydrates are an essential macronutrient that provide energy and nutrients for the mother and the fetus.Women with gestational diabetes should not avoid all carbohydrates, but rather choose complex carbohydrates that have a low glycemic index and limit the portion size.
Choice B is wrong because a sedentary lifestyle can increase the risk of developing type 2 diabetes after gestational diabetes.Women with gestational diabetes should be encouraged to be physically active for at least 30 minutes a day, most days of the week.
Choice D is wrong because monitoring blood glucose levels regularly is essential for managing gestational diabetes and preventing complications.Women with gestational diabetes should check their blood glucose levels at least four times a day: before breakfast and one hour after each meal.
Causes
A nurse is teaching a pregnant woman about gestational diabetes.
Which of the following statements by the nurse is correct?
Explanation
The correct answer is choice C.Gestational diabetes is caused by a hormonal imbalance that reduces insulin sensitivity.
Insulin is a hormone that helps the body use glucose for energy and control blood glucose levels.During pregnancy, the body makes special hormones and goes through other changes that can make the cells less responsive to insulin, a condition called insulin resistance.Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot and develop gestational diabetes.
Choice A is wrong because gestational diabetes is not caused by an autoimmune destruction of the pancreatic beta cells.This is the cause of type 1 diabetes, which usually develops in childhood or adolescence.
Choice B is wrong because gestational diabetes is not caused by a genetic mutation that impairs insulin secretion.This is the cause of some rare forms of diabetes, such as maturity-onset diabetes of the young (MODY) or neonatal diabetes mellitus (NDM).
Choice D is wrong because gestational diabetes is not caused by a viral infection that damages the insulin receptors.This is not a known cause of any type of diabetes.
Normal ranges for blood glucose levels during pregnancy are 3.5 to 5.9 mmol/L before meals and less than 7.8 mmol/L one hour after meals.
A nurse is caring for a pregnant woman who has gestational diabetes.
The nurse knows that the woman’s placenta produces hormones that have which of the following effects on her cells?
Explanation
The correct answer is choice C. They increase the resistance to insulin by the cells.This is because the placenta produces hormones such ashuman placental lactogen,growth hormone,prolactin,corticotropin-releasing hormone, andprogesteronethat can have a blocking effect on insulin.This is calledinsulin resistanceand it causes glucose to build up in the blood instead of being absorbed by the cells.
Choice A is wrong because the placental hormones do not increase the uptake of glucose by the cells, but rather decrease it by interfering with insulin action.
Choice B is wrong because the placental hormones do not decrease the production of glucose by the cells, but rather increase it by stimulating gluconeogenesis and glycogenolysis in the liver.
Choice D is wrong because the placental hormones do not decrease the breakdown of glucose by the cells, but rather increase it by stimulating lipolysis and ketogenesis in adipose tissue.
A nurse is providing education to a pregnant woman diagnosed with gestational diabetes.
The nurse explains that gestational diabetes primarily occurs due to:.
Explanation
The correct answer is choice A.Gestational diabetes primarily occurs due to hormonal changes during pregnancy affecting insulin production and action.
Insulin is a hormone that helps your body use glucose for energy and control your blood glucose levels.
During pregnancy, your body makes special hormones and goes through other changes that cause insulin resistance, meaning your cells don’t use insulin well.
Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot.These women develop gestational diabetes.
Choice B is wrong because genetic factors are not the main cause of gestational diabetes, although having a family history of diabetes may increase the risk.
Choice C is wrong because inadequate dietary intake of glucose during pregnancy does not cause gestational diabetes.However, eating healthy foods and controlling weight gain are important for managing gestational diabetes.
Choice D is wrong because an autoimmune response targeting the pancreas is not the cause of gestational diabetes.
Autoimmune diseases occur when your immune system attacks your own cells.Type 1 diabetes is an example of an autoimmune disease that affects the pancreas and causes insulin deficiency.
Gestational diabetes is not an autoimmune disease and does not affect the pancreas.
A client with gestational diabetes asks the nurse about the role of insulin in managing the condition.
The nurse responds by explaining that insulin helps:.
Explanation
The correct answer is choice A.Insulin helps reduce insulin resistance in the cells.
Insulin resistance is a condition in which the cells do not respond well to insulin and cannot use glucose effectively.
This causes high blood sugar levels, which can harm the mother and the baby.
Insulin therapy can help lower blood sugar levels by increasing the uptake of glucose by the cells.
Choice B is wrong because insulin does not decrease the production of hormones by the placenta.The placenta produces hormones that can make insulin less effective, but insulin does not affect the placenta’s hormone production.
Choice C is wrong because insulin does not increase blood sugar levels for optimal fetal growth.
Insulin lowers blood sugar levels by delivering glucose to the cells.High blood sugar levels can cause problems for the baby, such as being very large, having low blood sugar after birth, or developing type 2 diabetes later in life.
Choice D is wrong because insulin does not prevent the development of type 1 diabetes.
Type 1 diabetes is an autoimmune disease in which the body’s immune system destroys the insulin-producing cells in the pancreas.Gestational diabetes is not caused by a lack of insulin, but by other hormones produced during pregnancy that can make insulin less effective.Gestational diabetes usually goes away after delivery, but it can increase the risk of developing type 2 diabetes later in life.
A nurse is discussing the causes of gestational diabetes with a pregnant client.
The nurse emphasizes that gestational diabetes develops when:.
Explanation
The correct answer is choice A. The pancreas fails to produce enough insulin during pregnancy.This is because gestational diabetes occurs when the body can’t make the extra insulin needed during pregnancy.Insulin is a hormone that helps the body use glucose for energy and control blood sugar levels.During pregnancy, the body makes more hormones and goes through other changes, such as weight gain, that cause insulin resistance.This means that the body’s cells don’t use insulin well and the blood sugar levels rise.
Choice B is wrong because consuming excessive amounts of sugary foods during pregnancy does not cause gestational diabetes.However, eating healthy foods and avoiding processed and baked foods can help prevent or manage gestational diabetes.
Choice C is wrong because hormones produced by the placenta decrease insulin sensitivity in the cells, not increase it.This makes it harder for the body to use insulin and lowers the amount of glucose that enters the cells.
Choice D is wrong because insulin production by the pancreas is not inhibited by certain medications.
However, some medications may affect blood sugar levels and should be used with caution during pregnancy.Always consult your doctor before taking any medication if you have gestational diabetes or are at risk of developing it.
A client diagnosed with gestational diabetes expresses confusion about why the condition occurs during pregnancy.
The nurse explains that gestational diabetes is primarily related to:.
Explanation
The correct answer is choice C.Gestational diabetes is primarily related to the production of hormones by the placenta affecting insulin action.
Insulin is a hormone that helps your body use glucose for energy and control your blood glucose levels.
During pregnancy, your body makes special hormones and goes through other changes that cause insulin resistance, meaning your body’s cells don’t use insulin well.
Most pregnant women can produce enough insulin to overcome insulin resistance, but some cannot.These women develop gestational diabetes.
Choice A is wrong because changes in the client’s metabolic rate during pregnancy are not the main cause of gestational diabetes.
Metabolic rate refers to how fast your body uses energy.
While pregnancy can affect your metabolic rate, it does not directly affect your insulin production or action.
Choice B is wrong because an autoimmune response triggered by the growing fetus is not the cause of gestational diabetes.
An autoimmune response is when your immune system attacks your own cells or tissues.
Gestational diabetes is not an autoimmune disease, but a condition related to hormonal changes.
Choice D is wrong because genetic mutations inherited from the client’s parents are not the primary cause of gestational diabetes.
Genetic factors may play a role in increasing the risk of developing gestational diabetes, but they are not the only factor.Other factors such as being overweight, having a family history of diabetes, or being older than 30 may also increase the risk.
Risk Factors
A nurse is conducting an assessment on a pregnant client.
Which factor increases the client's risk of developing gestational diabetes?
Explanation
The correct answer is choice A. Age younger than 30 years old is not a risk factor for gestational diabetes.According to the CDC, some of the risk factors for gestational diabetes are:
• Being overweight or obese before pregnancy
• Having a family history of diabetes
• Being older than 25 years
• Having a history of polycystic ovary syndrome (PCOS)
• Having a previous baby weighing more than 9 pounds or having gestational diabetes before
Choice B is wrong because body mass index (BMI) below 25 is considered normal and does not increase the risk of gestational diabetes.A BMI of 25 or higher is considered overweight or obese and increases the risk of gestational diabetes.
Choice C is wrong because having a previous baby weighing more than 4.5 kg (10 lb) at birth is a risk factor for gestational diabetes, not the opposite.A large baby can indicate that the mother had high blood sugar during pregnancy and can cause complications during delivery.
Choice D is wrong because having a family history of diabetes is a risk factor for gestational diabetes, not the opposite.This means that if someone in your close family has diabetes, you are more likely to develop gestational diabetes.
A client with a history of polycystic ovary syndrome (PCOS) asks the nurse about the potential impact on her pregnancy.
The nurse explains that PCOS is a risk factor for:.
Explanation
The correct answer is choice B. Gestational diabetes.Polycystic ovary syndrome (PCOS) is a condition that affects the ovaries and hormones, and is associated with increased risk of gestational diabetes mellitus (GDM), which is a type of diabetes that only pregnant women get.Women with PCOS are more likely to have insulin resistance, obesity, and metabolic syndrome, which are risk factors for GDM.GDM can cause complications for both the mother and the baby, such as preeclampsia, large for gestational age baby, cesarean delivery, low blood sugar, and breathing problems.
Choice A is wrong because PCOS is not a risk factor for gestational hypertension, which is a sudden increase in blood pressure after the 20th week of pregnancy.Gestational hypertension can lead to preeclampsia, which can affect the mother’s kidneys, liver, and brain.PCOS may increase the risk of preeclampsia, but not directly of gestational hypertension.
Choice C is wrong because PCOS is not a risk factor for preterm labor, which is the delivery of the baby before 37 weeks of pregnancy.Preterm labor can cause health problems for the baby, such as breathing difficulties, bleeding in the brain, and infections.PCOS may increase the risk of preterm delivery due to other complications, such as preeclampsia or GDM, but not directly of preterm labor.
Choice D is wrong because PCOS is not a risk factor for ectopic pregnancy, which is when the fertilized egg implants outside the uterus, usually in the fallopian tube.Ectopic pregnancy can cause severe pain and bleeding, and can be life-threatening if not treated promptly.PCOS may affect the ovulation and fertility of women, but it does not increase the risk of ectopic pregnancy.
Normal ranges for blood glucose levels during pregnancy are:
• Fasting: less than 95 mg/dL
• One hour after meal: less than 140 mg/dL
• Two hours after meal: less than 120 mg/dL
A nurse is providing education to a pregnant woman with a family history of diabetes.
The nurse explains that having a parent or sibling with diabetes increases the risk of developing:.
Explanation
The correct answer is choice B. Gestational diabetes.Having a parent or sibling with diabetes increases the risk of developing gestational diabetes mellitus (GDM), a condition that affects the way the body processes glucose during pregnancy.GDM can cause complications for both the mother and the baby, such as high blood pressure, preterm labor, macrosomia, hypoglycemia and increased risk of type 2 diabetes later in life.
Choice A is wrong because preeclampsia is not directly related to diabetes, but rather to high blood pressure and proteinuria that can occur during pregnancy.Preeclampsia can affect the placenta, kidneys, liver and brain of the mother and can lead to eclampsia, a life-threatening condition that causes seizures.
Choice C is wrong because ectopic pregnancy is not related to diabetes, but rather to a fertilized egg implanting outside the uterus, usually in the fallopian tube.
Ectopic pregnancy can cause severe bleeding and damage to the reproductive organs and can be fatal if not treated promptly.
Choice D is wrong because preterm labor is not caused by diabetes alone, but rather by a combination of factors that can trigger contractions before 37 weeks of gestation.
Some of these factors include infections, dehydration, multiple pregnancy, placental problems and stress.
A client is concerned about her increased risk of developing gestational diabetes due to her ethnic background.
The nurse explains that which ethnic origin is associated with a higher risk of gestational diabetes?
Explanation
The correct answer is choice C. Native American.According to UpToDate, Native American women have a higher risk of gestational diabetes than other ethnic groups.
Gestational diabetes is a condition that occurs when the body cannot produce enough insulin or use it effectively during pregnancy, leading to high blood sugar levels.
Choice A is wrong because Caucasian women have a lower risk of gestational diabetes than other ethnic groups.
Choice B is wrong because Hispanic women have an intermediate risk of gestational diabetes, lower than Native American but higher than Caucasian.
Choice D is wrong because Pacific Islander women have a similar risk of gestational diabetes as Hispanic women, lower than Native American but higher than Caucasian.
Normal ranges for fasting blood glucose are 60 to 99 mg/dL and for 1-hour glucose screening are less than 140 mg/dL.
Danielle’s fasting 1-hour glucose screening level of 164 mg/dL was above the normal range and indicated the need for further testing.
A nurse is reviewing the risk factors for gestational diabetes with a pregnant client.
Which factor increases the client's risk?
Explanation
The correct answer is choice A. Previous history of gestational diabetes.This is because having gestational diabetes (GDM) in a previous pregnancy increases the risk of developing it again in a subsequent pregnancy.GDM is a condition where the blood sugar (glucose) is higher than normal during pregnancy.
Choice B is wrong because normal body mass index (BMI) does not increase the risk of GDM.In fact, being overweight or obese is a risk factor for GDM.
Choice C is wrong because having a family history of diabetes is a risk factor for GDM.
This means that having relatives with diabetes increases the likelihood of developing GDM.
Choice D is wrong because being younger than 25 years old does not increase the risk of GDM.In fact, being older than 25 years old is a risk factor for GDM.
Normal ranges for blood glucose during pregnancy are 60-99 mg/dL before meals and less than 140 mg/dL one hour after meals.
Symptoms
A nurse is assessing a pregnant client who reports increased urination and excessive thirst.
These symptoms are most likely indicative of:.
Explanation
The correct answer is choice A. Gestational diabetes is a condition in which women develop high blood sugar during pregnancy.It may not cause any symptoms at first, but as it progresses, it may cause increased thirst, frequent urination, excessive sweating, fatigue and overweight.
These symptoms are most likely indicative of gestational diabetes because they are similar to the symptoms of type 2 diabetes, which is also caused by insulin resistance.
Choice B is wrong because urinary tract infection (UTI) is an infection of the urinary system that can cause pain or burning during urination, cloudy or bloody urine, fever, pelvic pain or pressure and lower back pain.
These symptoms are different from those of gestational diabetes.
Choice C is wrong because dehydration is a condition in which the body loses more water than it takes in.It can cause dry mouth, thirst, headache, dizziness, fatigue and decreased urine output.
These symptoms are not specific to gestational diabetes and can be caused by many other factors.
Choice D is wrong because preterm labor is a condition in which contractions start before the 37th week of pregnancy
A client presents to the healthcare clinic with complaints of fatigue and blurred vision during her pregnancy.
The nurse suspects these symptoms may be related to:.
Explanation
The correct answer is choice A. Gestational diabetes is a condition in which women develop high blood sugar during pregnancy.It may cause symptoms such as increased thirst, frequent urination, excessive sweating, overweight, and fatigue.Blurred vision can also be a sign of high blood sugar.
Choice B is wrong because iron deficiency anemia causes symptoms such as pale skin, weakness, shortness of breath, and fast heartbeat.
It does not cause blurred vision.
Choice C is wrong because hypertensive disorder of pregnancy causes symptoms such as high blood pressure, headache, swelling of the hands and feet, and protein in the urine.
It may cause blurred vision in severe cases, but it is not the most likely cause of the client’s symptoms.
Choice D is wrong because preterm labor causes symptoms such as regular contractions, lower back pain, pelvic pressure, and vaginal bleeding or discharge.
It does not cause blurred vision.
A nurse is providing education to a pregnant client who reports experiencing recurrent vaginal yeast infections.
The nurse explains that these infections may be associated with:.
Explanation
The correct answer is choice B.Hormonal changes during pregnancy can disrupt the normal balance of yeast and bacteria in the vagina and make it easier for yeast to grow and stick to the vaginal walls.Yeast infection during pregnancy can cause discomfort, itching, burning, and swelling in the vulva, as well as white, lumpy, and odorless discharge.
Choice A is wrong because gestational diabetes is not a direct cause of yeast infection, although it can increase the risk of getting one if the blood sugar levels are not well controlled.
Choice C is wrong because sexual activity is not a direct cause of yeast infection, although it can spread the infection from one partner to another or introduce new strains of yeast into the vagina.
Choice D is wrong because poor hygiene practices are not a direct cause of yeast infection, although they can worsen the symptoms or increase the risk of other infections.In fact, douching or using vaginal sprays can alter the vaginal pH and make yeast infection more likely.
A client presents with complaints of excessive sweating and genital itching during her pregnancy.
The nurse suspects these symptoms may be related to:.
Explanation
The correct answer is choice C. Hormonal changes during pregnancy.Hormonal changes can cause various symptoms during pregnancy, such as excessive sweating, vaginal dryness, and vaginal itching.
These symptoms are usually normal and common, but they can be uncomfortable and bothersome.
Choice A is wrong because gestational diabetes does not cause excessive sweating or genital itching.
Gestational diabetes is a type of diabetes that develops during pregnancy and affects how the body processes glucose (sugar).
Some of the symptoms of gestational diabetes are increased thirst, frequent urination, blurred vision, and fatigue.
Choice B is wrong because allergic reaction to medication does not cause excessive sweating or genital itching.
Allergic reaction to medication is a serious condition that can cause symptoms such as rash, hives, swelling, difficulty breathing, and anaphylaxis (a life-threatening reaction that affects the whole body).
Choice D is wrong because preterm labor does not cause excessive sweating or genital itching.
Preterm labor is a condition that occurs when the uterus contracts and the cervix opens before 37 weeks of pregnancy.
Some of the symptoms of preterm labor are regular contractions, lower back pain, pelvic pressure, abdominal cramps, and vaginal bleeding or discharge.
Normal ranges for excessive sweating and genital itching during pregnancy are not well-defined, as they may vary depending on individual factors such as body temperature, hygiene, clothing, and environment.
However, some general tips to cope with these symptoms are:
• Wear loose-fitting, breathable clothing made of natural fibers such as cotton
• Avoid synthetic fabrics, tight clothes, and underwear that trap heat and moisture
• Use mild soap and water to wash the genital area gently and pat it dry
• Avoid douching, perfumed products, and harsh chemicals that can irritate the skin
• Apply a moisturizer or lubricant to relieve vaginal dryness
• Use a cool compress or ice pack to soothe itching
• Keep hydrated by drinking plenty of fluids
• Consult your doctor if you have any signs of infection such as foul-smelling discharge, redness, swelling, pain, or fever
A pregnant client reports frequent episodes of urinary tract infections.
The nurse recognizes that this symptom may be associated with:.
Explanation
The correct answer is choice C.Hormonal changes during pregnancy can cause changes in the urinary tract, such as vesicoureteral reflux, which increases the risk of urinary tract infections (UTIs).UTIs are common during pregnancy and can lead to complications such as preterm labor and low birth weight if left untreated.
Choice A is wrong because gestational diabetes does not directly cause UTIs, although it may increase the risk of developing them due to high blood sugar levels.
Choice B is wrong because poor hygiene practices are not the main cause of UTIs during pregnancy, although they may contribute to the spread of bacteria from the rectum to the urethra.
Choice D is wrong because preterm labor is a possible consequence of UTIs, not a cause of them.
A nurse is screening a pregnant woman for gestational diabetes.
The nurse should ask the woman about which of the following symptoms that may indicate high blood sugar levels?
Explanation
The correct answer is choice C.Frequent urination and thirst are common symptoms of high blood sugar levels.Gestational diabetes is a condition in which women develop diabetes during pregnancy due to hormonal changes or other factors.It can affect the health of both the mother and the baby if not managed well.
Choice A is wrong because nausea and vomiting are not specific symptoms of gestational diabetes.They can occur in normal pregnancy or other conditions.
Choice B is wrong because headache and dizziness are also not specific symptoms of gestational diabetes.They can be caused by dehydration, low blood pressure, or other factors.
Choice D is wrong because abdominal pain and cramps are not typical symptoms of gestational diabetes.They can be signs of preterm labor, infection, or other problems.
Normal ranges for blood sugar levels during pregnancy are:
• Before meals: 60 to 90 mg/dL
• One hour after meals: 100 to 120 mg/dL
• Two hours after meals: 100 to 120 mg/dL
Screening and Diagnosis
A nurse is providing education to a pregnant client about the screening test for gestational diabetes.
The nurse explains that the test involves measuring blood sugar levels at different time points.
Which of the following blood sugar level readings would confirm a diagnosis of gestational diabetes?
Explanation
The correct answer is choice C. Fasting: 90 mg/dL, 1 hour: 185 mg/dL, 2 hours: 160 mg/dL.
This is because these blood sugar levels exceed the normal ranges for a pregnant woman undergoing a screening test for gestational diabetes.
The normal ranges are:
• Fasting: less than 95 mg/dL
• 1 hour: less than 180 mg/dL
• 2 hours: less than 155 mg/dL
Choice A is wrong because these blood sugar levels are within the normal ranges.
Choice B is wrong because only the fasting blood sugar level is slightly above the normal range, but not enough to confirm a diagnosis of gestational diabetes.
Choice D is wrong because only the 1 hour and 2 hours blood sugar levels are slightly above the normal ranges, but not enough to confirm a diagnosis of gestational diabetes.
A client undergoes the screening test for gestational diabetes.
The nurse reviews the client's blood sugar level results.
The fasting blood sugar level is 89 mg/dL, the 1-hour level is 178 mg/dL, and the 2-hour level is 150 mg/dL.
Based on these results, the nurse would interpret them as indicating:.
Explanation
The correct answer is choice B. Impaired glucose tolerance.
This means that the client’s blood sugar levels are higher than normal but not high enough to be diagnosed with diabetes.According to the Mayo Clinic, a normal blood glucose level two hours after drinking the glucose solution is lower than 140 mg/dL (7.8 mmol/L).
A level between 140 and 199 mg/dL (7.8 and 11 mmol/L) indicates impaired glucose tolerance, and a level of 200 mg/dL (11.1 mmol/L) or higher indicates diabetes.
Choice A is wrong because normal glucose tolerance means that the blood sugar levels are within the normal range after drinking the glucose solution.
The client’s 1-hour and 2-hour levels are above the normal range.
Choice C is wrong because gestational diabetes means that the blood sugar levels are too high during pregnancy and can cause complications for the mother and the baby.
The client’s fasting blood sugar level is within the normal range,
A nurse is preparing to perform the glucose tolerance test for a pregnant client.
Which of the following statements by the client indicates a need for further clarification?
Explanation
The correct answer is choice D.“I will be required to stay in the clinic for several hours during the test.” This statement indicates a need for further clarification because the glucose tolerance test for a pregnant client usually takes 1 hour, not several hours.The client should be informed that she will need to have blood drawn at fasting and 1 hour after drinking the sugary drink.
Choice A is wrong because it is correct that the client should not eat or drink anything after midnight before the test.
Choice B is wrong because it is correct that the client will need to have blood drawn at fasting and after drinking the sugary drink.
Choice C is wrong because it is correct that the sugary drink may taste sweet and cause some temporary discomfort.
The normal range for blood glucose level after a 1-hour glucose tolerance test is less than 140 mg/dL.A blood glucose level of 130 to 140 mg/dL is considered a positive screening and requires a 3-hour glucose tolerance test to confirm gestational diabetes mellitus.
A client is scheduled to undergo the glucose tolerance test for gestational diabetes screening.
The nurse provides instructions to the client.
Which statement by the client indicates an understanding of the procedure?
Explanation
The correct answer is choice B.“I can drink water during the test to stay hydrated.” This statement indicates an understanding of the procedure because water does not affect the blood glucose level and can help prevent dehydration during the test.
Choice A is wrong because “I should avoid any high-sugar foods for a week before the test.” This statement is incorrect because the client only needs to avoid eating or drinking anything except water for at least eight hours before the test.
Avoiding high-sugar foods for a week before the test is unnecessary and may alter the results.
Choice C is wrong because “I need to fast for 12 hours before the test.” This statement is incorrect because the client only needs to fast for eight hours before the test.
Fasting for longer than eight hours may cause hypoglycemia (low blood sugar) or ketosis (high levels of ketones in the blood).
Choice D is wrong because “I should avoid physical activity on the day of the test.” This statement is incorrect because moderate physical activity does not affect the blood glucose level and may help reduce stress during the test.
However, strenuous exercise should be avoided as it may lower the blood glucose level too much.
Normal ranges for blood glucose levels during the glucose tolerance test are:
• Fasting: less than 5.3 mmol/L (95 mg/dL)
• One hour: less than 10.0 mmol/L (180 mg/dL)
• Two hours: less than 8.6 mmol/L (155 mg/dL)
A pregnant client has just completed the glucose tolerance test for gestational diabetes.
The nurse reviews the client's blood sugar level results.
The fasting blood sugar level was 95 mg/dL, the 1-hour level was 175 mg/dL, and the 2-hour level was 145 mg/dL.
Based on these results, the nurse would interpret them as indicating:.
Explanation
The correct answer is choice B. Impaired glucose tolerance.This means that the blood sugar levels are higher than normal, but not high enough to diagnose gestational diabetes.The normal ranges for the glucose tolerance test for gestational diabetes are:
• Fasting blood sugar level: less than 95 mg/dL (5.3 mmol/L)
• 1-hour level: less than 180 mg/dL (10 mmol/L)
• 2-hour level: less than 155 mg/dL (8.6 mmol/L)
The client’s fasting blood sugar level was within the normal range, but the 1-hour and 2-hour levels were above the normal range, indicating impaired glucose tolerance.
Choice A is wrong because normal glucose tolerance means that the blood sugar levels are within the normal range for all three measurements.
Choice C is wrong because gestational diabetes means that the blood sugar levels are above the diagnostic threshold for all three measurements:
• Fasting blood sugar level: 92 mg/dL (5.1 mmol/L) or higher
• 1-hour level: 180 mg/dL (10 mmol/L) or higher
• 2-hour level: 153 mg/dL (8.5 mmol/L) or higher
Choice D is wrong because pre-existing diabetes means that the blood sugar levels are above the diagnostic threshold for diabetes before pregnancy:
• Fasting blood sugar level: 126 mg/dL (7 mmol/L) or higher
• Random blood sugar level: 200 mg/dL (11.1 mmol/L) or higher
A nurse is reviewing the antenatal care plan for a pregnant woman who has no risk factors for gestational diabetes.
The nurse should expect the woman to have which of the following tests to screen for gestational diabetes?
Explanation
The correct answer is choice C. Glucose tolerance test at 24 to 28 weeks of gestation.This is the recommended screening test for gestational diabetes mellitus (GDM) for women who have no risk factors.
The test involves measuring the blood glucose level one hour after ingesting a 50-gram glucose load.If the result is abnormal (greater than 140 mg/dL), a diagnostic three-hour oral glucose tolerance test (OGTT) is performed.
Choice A is wrong because fasting blood glucose test is not a screening test for GDM, but a diagnostic test that requires an overnight fast and measures the blood glucose level before eating.
It is usually done as part of the OGTT.
Choice B is wrong because random blood glucose test is not a reliable screening test for GDM, as it does not account for the timing and content of the last meal.
Choice D is wrong because hemoglobin A1c test is not a screening test for GDM, but a test that measures the average blood glucose level over the past two to three months.It is used to monitor the glycemic control of women with preexisting diabetes mellitus during pregnancy.
Complications
A 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.
•
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.
Treatment
A client with gestational diabetes asks the nurse about the preferred medication for controlling blood sugar levels.
The nurse explains that the preferred medication is chosen because it does not cross the placenta and affect the baby.
Which medication is the nurse referring to?
Explanation
The correct answer is choice A. Insulin injections.Insulin is the preferred medication for controlling blood sugar levels in gestational diabetes because it does not cross the placenta and affect the baby.Insulin lowers blood glucose by stimulating glucose uptake in muscle and fat cells and inhibiting glucose production in the liver.
Choice B.Metformin is wrong because metformin is an oral antidiabetic drug that can cross the placenta and may have unknown effects on the baby.Metformin works by decreasing glucose production in the liver and increasing insulin sensitivity in muscle and fat cells.
Choice C.Glyburide is wrong because glyburide is another oral antidiabetic drug that can cross the placenta and may cause hypoglycemia or other adverse effects in the baby.Glyburide works by stimulating insulin secretion from the pancreas and increasing insulin sensitivity in peripheral tissues.
Choice D.Oral corticosteroids are wrong because oral corticosteroids are not used to treat gestational diabetes, but rather to accelerate fetal lung maturation in preterm labor.Oral corticosteroids can actually increase blood glucose levels by stimulating gluconeogenesis and decreasing insulin sensitivity.
A nurse is teaching a client with gestational diabetes about the importance of regular antenatal visits.
Which of the following is a primary reason for these visits?
Explanation
The correct answer is choice A. To monitor the progress of pregnancy and check for any complications.This is the primary reason for regular antenatal visits for women with gestational diabetes, as they are at increased risk of developing hypertension, preeclampsia, polyhydramnios, and fetal macrosomia.These visits also allow the health care provider to monitor the blood glucose levels and adjust the treatment plan accordingly.
Choice B is wrong because insulin injections are not always required for women with gestational diabetes.Some women can manage their blood sugar levels with dietary modifications and exercise alone.
Choice C is wrong because ultrasound scans are not the primary reason for antenatal visits, although they may be performed more frequently for women with gestational diabetes to assess the fetal growth and well-being.
Choice D is wrong because education on dietary modifications during pregnancy is not the primary reason for antenatal visits, although it is an important component of the management of gestational diabetes.Women with gestational diabetes should receive individualized nutrition counseling from a registered dietitian or a certified diabetes educator.
A client with gestational diabetes asks the nurse about the role of exercise in managing blood sugar levels.
The nurse explains that exercise can help lower blood sugar levels and improve insulin sensitivity.
How many minutes of moderate physical activity per day is recommended for this client, unless advised otherwise by a healthcare provider?
Explanation
The correct answer is choice C. 30 minutes.According to the CDC, the American Diabetes Association, and other sources, exercise can help lower blood sugar levels and improve insulin sensitivity for women with gestational diabetes.
It is recommended that they get at least30 minutesof moderate-intensity physical activity at leastfive days a week, unless advised otherwise by a healthcare provider.
Choice A is wrong because 10 minutes of exercise per day is too low to have a significant effect on blood sugar levels and insulin sensitivity.
Choice B is wrong because 20 minutes of exercise per day is also below the recommended amount for women with gestational diabetes.
Choice D is wrong because 60 minutes of exercise per day may be too much for some women with gestational diabetes, especially if they have other complications or risk factors.
They should consult their healthcare provider before engaging in such a high level of physical activity.
Normal ranges for blood sugar levels during pregnancy are:
• Fasting: less than 95 mg/dL
• One hour after a meal: less than 140 mg/dL
• Two hours after a meal: less than 120 mg/dL
A nurse is discussing the use of medication for gestational diabetes with a client.
Which statement accurately describes the use of oral antidiabetic drugs such as metformin or glyburide?
Explanation
The correct answer is choice C. They are used in cases where diet and exercise are not sufficient to control blood sugar levels.According to a study by Langer et al, oral antidiabetic drugs such as glyburide and metformin are equivalent to insulin in terms of pregnancy outcomes in gestational diabetes mellitus (GDM).These drugs can help lower blood sugar levels by stimulating the release of insulin from the pancreas, limiting the liver’s production of glucose, or improving the cells’ sensitivity to insulin.
Choice A is wrong because they are not the first-line treatment option for gestational diabetes.The first-line treatment is diet and exercise, which can help control blood sugar levels in most cases of GDM.
Choice B is wrong because they are not necessarily contraindicated during pregnancy.Although there are some potential risks to the baby, such as hypoglycemia or fetal growth restriction, these can be minimized by careful monitoring and dose adjustment.
Choice D is wrong because they are not preferred over insulin injections for their ease of use and convenience.Insulin injections are still the gold standard for treating GDM, especially in cases of severe hyperglycemia or when oral drugs fail to achieve adequate glycemic control.Insulin injections also have fewer side effects and interactions than oral drugs.
A nurse is providing dietary education to a pregnant woman who has gestational diabetes.
The nurse should advise the woman to consume how many calories per day during the third trimester of pregnancy?
Explanation
The correct answer is choice D. 2400 calories.A pregnant woman with gestational diabetes should consume about 2400 calories per day during the third trimester of pregnancy.This is based on the average energy requirement for a pregnant woman, which is about 2200 calories per day plus 200 calories for the baby’s growth.
A woman who is overweight before pregnancy may need fewer calories than this.
Choice A. 1800 calories is wrong because it is too low for a pregnant woman with gestational diabetes.Eating too few calories can cause ketones to build up in the blood, which can harm the baby.
Choice B. 2000 calories is wrong because it is also too low for a pregnant woman with gestational diabetes.It may not provide enough energy and nutrients for the mother and the baby.
Choice C. 2200 calories is wrong because it is the average energy requirement for a pregnant woman without gestational diabetes.A woman with gestational diabetes needs an extra 200 calories per day to support the baby’s growth and development.
A nurse is teaching a pregnant woman who has gestational diabetes about the benefits of exercise during pregnancy.
The nurse should explain that exercise can help the woman by doing which of the following?
Explanation
The correct answer is choice D.Exercise can help the woman by enhancing her insulin sensitivity and glucose utilization.
This means that her body can use the glucose in her blood more efficiently and lower her blood sugar levels.Exercise can also help prevent excess weight gain, which is a risk factor for gestational diabetes.
Choice A is wrong because exercise does not increase appetite and caloric intake, but rather helps regulate them.
Choice B is wrong because exercise does not lower blood pressure and heart rate, but rather increases them temporarily during physical activity.Choice C is wrong because exercise does not reduce the risk of preterm labor and delivery, but rather may increase it if done excessively or without proper supervision.
Nursing Interventions
A nurse is teaching a pregnant woman about gestational diabetes screening.
Which statement indicates understanding?
Explanation
The correct answer is choice A.“I should have the oral glucose tolerance test between 24 and 28 weeks of gestation.” This statement indicates understanding because it reflects the current recommendation for gestational diabetes screening for all pregnant women.The oral glucose tolerance test (OGTT) measures how the body handles glucose after a glucose load and can detect impaired glucose tolerance or diabetes.
Choice B is wrong because the woman does not need to eat a high-carbohydrate meal before the screening test.In fact, she should fast for at least 8 hours before the test.
Choice C is wrong because the screening process is necessary even if the woman has no family history of diabetes.Gestational diabetes can occur in any pregnant woman, especially if she has risk factors such as obesity, advanced maternal age, previous history of gestational diabetes, or a history of polycystic ovary syndrome.
Choice D is wrong because the screening test should not be done at any time during the pregnancy.The optimal time for screening is between 24 and 28 weeks of gestation, when insulin resistance peaks due to placental hormones.If the test is done too early or too late, it may miss some cases of gestational diabetes or give false-positive results.
A nurse is developing a meal plan for a pregnant woman with gestational diabetes.
Which instruction should the nurse include?
Explanation
The correct answer is choice A.“Consume regular meals and snacks to maintain stable blood glucose levels.” This is because eating at regular intervals helps prevent blood sugar spikes and drops, which can be harmful for both the mother and the baby.A healthy diet for gestational diabetes should include a variety of foods from different food groups, such as fruits, vegetables, whole grains, lean proteins, and low-fat dairy products.
Choice B is wrong because “Avoid fruits and vegetables to minimize carbohydrate intake.” Fruits and vegetables are rich in vitamins, minerals, antioxidants, and fiber, which are beneficial for both the mother and the baby.Carbohydrates are not bad for gestational diabetes, as long as they are complex carbohydrates that are digested slowly and do not cause rapid blood sugar spikes.Examples of complex carbohydrates are whole wheat bread, brown rice, oats, quinoa, beans, and lentils.
Choice C is wrong because “Focus on consuming high-fat foods to meet nutritional needs.” High-fat foods can increase the risk of weight gain, high cholesterol, high blood pressure, and heart disease, which can complicate gestational diabetes.
Moreover, not all fats are healthy.Saturated fats and trans fats should be avoided or limited, as they can raise bad cholesterol levels and increase inflammation.Examples of saturated fats are butter, cheese, cream, fatty meats, and coconut oil.Examples of trans fats are margarine, shortening, baked goods, fried foods, and processed snacks.Healthy fats are unsaturated fats that can lower bad cholesterol levels and provide essential fatty acids.
Examples of unsaturated fats
A nurse is educating a pregnant woman with gestational diabetes about physical activity.
Which statement by the client indicates understanding?
Explanation
The correct answer is choice A.“I should engage in moderate-intensity exercises like walking or swimming.” This statement indicates that the client understands the benefits of physical activity for gestational diabetes, such as improving glucose metabolism, reducing insulin resistance, and preventing excessive weight gain.Moderate-intensity exercises are recommended for pregnant women with gestational diabetes, as long as they are medically cleared and have no contraindications.
Choice B is wrong because physical activity does not cause complications for gestational diabetes, but rather helps to prevent them.Avoiding physical activity can lead to poor glycemic control, increased risk of hypertension, preeclampsia, and cesarean delivery.
Choice C is wrong because exercise should be done throughout pregnancy, not only in the third trimester.Starting exercise early in pregnancy can help to prevent or delay the onset of gestational diabetes, and continuing exercise until delivery can help to maintain glucose levels and prevent fetal macrosomia.
Choice D is wrong because high-intensity exercises are not recommended for pregnant women with gestational diabetes, as they can cause hypoglycemia, dehydration, and fetal distress.High-intensity exercises can also increase the production of stress hormones, which can impair glucose metabolism and increase insulin resistance.
A nurse is teaching a pregnant woman with gestational diabetes about blood glucose monitoring.
Which instruction should the nurse provide?
Explanation
The correct answer is choice A. “Perform self-monitoring of blood glucose using a glucometer.” This instruction will help the pregnant woman with gestational diabetes to monitor her blood glucose levels and adjust her insulin dosage accordingly.Self-monitoring of blood glucose is recommended at least four times a day for women with gestational diabetes.
Choice B is wrong because “Check blood glucose levels once a week.” is not frequent enough to ensure adequate glycemic control.Women with gestational diabetes need to check their blood glucose levels daily or more often.
Choice C is wrong because “Maintaining blood glucose levels within the recommended range is not necessary.” is false and dangerous.Maintaining blood glucose levels within the recommended range is essential to prevent maternal and fetal complications such as macrosomia, hypoglycemia, congenital anomalies, and preeclampsia.
Choice D is wrong because “Ignore symptoms of hypoglycemia and hyperglycemia.” is also false and dangerous.
Symptoms of hypoglycemia and hyperglycemia should not be ignored, but reported to the health care provider and treated promptly.
Hypoglycemia can cause maternal seizures, coma, and death.Hyperglycemia can cause fetal distress, stillbirth, and neonatal death.
The normal range for fasting blood glucose in pregnancy is 60 to 95 mg/dL.The normal range for postprandial blood glucose in pregnancy is 100 to 129 mg/dL.
A nurse is providing education to a pregnant woman who may require insulin therapy for gestational diabetes.
Which information should the nurse include?
Explanation
The correct answer is choice A. Insulin administration may be necessary if dietary modifications and physical activity alone are insufficient.
This is because gestational diabetes mellitus (GDM) is a condition that affects the way the body uses glucose during pregnancy, and it can cause high blood sugar levels that can affect the health of both the mother and the baby.Insulin is a hormone that helps the body use glucose for energy, and some women with GDM may need to take insulin injections to keep their blood sugar levels within normal range.
Choice B is wrong because skipping insulin doses can lead to dangerously high blood sugar levels that can cause complications such as ketoacidosis, fetal distress, preterm labor, or stillbirth.
Women with GDM should follow their prescribed insulin regimen and monitor their blood sugar levels regularly.
Choice C is wrong because insulin therapy is not the first-line treatment for GDM.The first-line treatment for GDM is lifestyle changes such as eating a balanced diet, limiting carbohydrates and sweets, increasing fiber intake, and exercising moderately for at least 30 minutes a day.
These measures can help lower blood sugar levels and reduce the need for insulin therapy.
However, if lifestyle changes are not enough to control blood sugar levels, insulin therapy may be added as a second-line treatment.
Choice D is wrong because insulin cannot be administered at any time during the day.
Insulin therapy for GDM requires careful timing and dosing to match the blood sugar patterns and needs of each woman.Insulin therapy for GDM usually involves a combination of short-acting and intermediate-acting insulin that are given before meals and at bedtime.
The timing and dosage of insulin depend on factors such as the woman’s weight, blood sugar levels, diet, activity level, and fetal growth.
Women with GDM should consult their health care provider or diabetes educator about their individualized insulin regimen.
A nurse is screening a pregnant woman for gestational diabetes using an oral glucose tolerance test (OGTT).
The nurse should instruct the woman to do which of the following before the test?
Explanation
The correct answer is choice B. Drink water only for 8 hours before the test.This is because the oral glucose tolerance test (OGTT) requires fasting for about 8 hours before the test to get accurate results.
The woman should not eat or drink anything except water during this time.
Choice A is wrong because eating a high-carbohydrate meal the night before can raise the blood glucose level and affect the test results.
Choice C is wrong because caffeine and smoking can also affect the blood glucose level and interfere with the test results.
Choice D is wrong because some medications can alter the blood glucose level and cause false-positive or false-negative results.The woman should consult her doctor about taking her usual medications before the test.
Normal ranges for OGTT vary depending on the laboratory and the type of glucose solution used.Generally, a normal fasting blood glucose level is less than 100 mg/dL, a normal 1-hour level is less than 180 mg/dL, a normal 2-hour level is less than 155 mg/dL, and a normal 3-hour level is less than 140 mg/dL.
More questions on this topic
In gestational diabetes, the condition primarily affects the?
Explanation
The correct answer is choice C. Pancreas.Gestational diabetes is a type of diabetes that develops during pregnancy and affects how the cells use sugar (glucose).Glucose is the main source of energy for the body and it is regulated by a hormone called insulin, which is produced by the pancreas.
In gestational diabetes, the placenta (the organ that connects the baby to the mother) produces hormones that can make insulin less effective, leading to high blood sugar levels.This condition is called insulin resistance
Choice A is wrong because the lungs are not directly involved in glucose metabolism or insulin production.
Choice B is wrong because the kidneys are not the primary site of insulin production, although they can be affected by high blood sugar levels over time.
Choice D is wrong because the liver is not the main source of insulin, although it can help regulate blood sugar levels by storing and releasing glucose as needed.
Gestational diabetes usually does not cause any symptoms, but it can increase the risk of complications for both the mother and the baby, such as high blood pressure, pre-eclampsia, large birth weight, premature delivery, low blood sugar, and future diabetesTherefore, it is important to screen for gestational diabetes during pregnancy and manage it with a healthy diet, exercise, and medication if needed
The primary risk factor for gestational diabetes is?
Explanation
The correct answer is choice D. Previous history of gestational diabetes.This is because having gestational diabetes in a previous pregnancy increases the risk of developing it again in a subsequent pregnancy.According to the CDC, about 50% of women with gestational diabetes go on to develop type 2 diabetes later in life.
Choice A is wrong because advanced maternal age is not a primary risk factor for gestational diabetes, although it may increase the risk slightly.
Choice B is wrong because family history of diabetes is not a primary risk factor for gestational diabetes, although it may indicate a genetic predisposition to insulin resistance.
Choice C is wrong because smoking during pregnancy is not a primary risk factor for gestational diabetes, although it may have other adverse effects on the mother and the baby.
Some of the other risk factors for gestational diabetes include obesity, hormonal changes, polycystic ovary syndrome, and pregnancy over 30 years of age.Gestational diabetes can cause complications such as high blood pressure, preeclampsia, large birth weight, premature delivery, respiratory distress syndrome, and low blood sugar in the baby.Gestational diabetes can be managed with a healthy diet, exercise, and medication if needed.
Gestational diabetes is most likely to develop during which trimester of pregnancy?
Explanation
The correct answer is choice B. Second trimester.
Gestational diabetes is high blood sugar that develops during pregnancy and usually disappears after giving birth.It can happen at any stage of pregnancy, but is more common in the second or third trimester.This is because hormonal changes that occur during pregnancy can affect the body’s ability to produce enough insulin, a hormone that helps control blood sugar levels.
Choice A is wrong because gestational diabetes is less likely to develop during the first trimester, when the hormonal changes are not as significant.
Choice C is wrong because gestational diabetes is usually diagnosed and treated before the third trimester, to prevent complications for the mother and the baby.
Choice D is wrong because gestational diabetes is not a postpartum condition, although some women may have a higher risk of developing type 2 diabetes later in life if they had gestational diabetes.
Normal ranges for blood sugar levels during pregnancy are:
• Before meals: 60 to 95 mg/dL
• One hour after meals: 100 to 129 mg/dL
• Two hours after meals: 70 to 119 mg/dL
Gestational diabetes increases the risk of which of the following complications during pregnancy?
Explanation
The correct answer is choice B. Preeclampsia.Gestational diabetes increases the risk of high blood pressure and preeclampsia, a serious complication of pregnancy that causes high blood pressure and other symptoms that can threaten both the mother’s and the baby’s life.
Choice A is wrong because preterm labor is not directly caused by gestational diabetes, although it may be done to prevent complications from preeclampsia or a large baby.
Choice C is wrong because ectopic pregnancy is not related to gestational diabetes.Ectopic pregnancy occurs when the fertilized egg implants outside the uterus, usually in the fallopian tube.
Choice D is wrong because placenta previa is not associated with gestational diabetes.Placenta previa occurs when the placenta covers part or all of the opening of the cervix.
The long-term implications of gestational diabetes primarily include an increased risk of developing
Explanation
The correct answer is
C. Type 2 diabetes.
Gestational diabetes (GDM) is a condition where the blood sugar levels are higher than normal during pregnancy.It usually goes away after giving birth, but it can increase the risk of developing type 2 diabetes later in life.
Type 2 diabetes is a chronic condition that affects how the body uses glucose (sugar) for energy.It can cause serious complications such as heart disease, kidney damage, nerve damage, eye problems and more.
A. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and other body functions.
It can cause symptoms such as fatigue, weight gain, depression, dry skin and hair loss.Hypothyroidism is not directly linked to gestational diabetes, but it can affect pregnancy outcomes and increase the risk of miscarriage, preterm birth and low birth weight.
B. Asthma is a condition where the airways become inflamed and narrow, making it hard to breathe.
It can cause symptoms such as wheezing, coughing, chest tightness and shortness of breath.Asthma is not directly linked to gestational diabetes, but it can affect pregnancy outcomes and increase the risk of preterm birth, low birth weight and preeclampsia.
D. Breast cancer is a type of cancer that starts in the breast tissue.
It can cause symptoms such as a lump in the breast, nipple discharge, skin changes and pain.Breast cancer is not directly linked to gestational diabetes, but it can be influenced by hormonal factors such as estrogen and progesterone levels, which may change during pregnancy and after menopause.
A nurse is reviewing the laboratory results of a pregnant woman who has gestational diabetes.
The nurse expects to find which of the following findings?
Explanation
The correct answer is
A. Elevated fasting blood glucose levels.
Gestational diabetes (GDM) is a condition where the blood sugar levels are higher than normal during pregnancy.
It can affect the health of the mother and the baby if not well controlled.GDM usually goes away after delivery, but it can increase the risk of developing type 2 diabetes later in life.
A. Elevated fasting blood glucose levels.
This statement is true.
Fasting blood glucose levels are the levels of glucose in the blood after not eating or drinking anything except water for at least 8 hours.
Normal fasting blood glucose levels are between 70 and 100 mg/dL (3.9 and 5.6 mmol/L).
In GDM, the fasting blood glucose levels are higher than normal, usually above 95 mg/dL (5.3 mmol/L).This indicates that the body is not able to use insulin effectively to lower the blood sugar levels.
B. Decreased postprandial blood glucose levels.
This statement is false.
Postprandial blood glucose levels are the levels of glucose in the blood after eating a meal or a snack.
Normal postprandial blood glucose levels are below 140 mg/dL (7.8 mmol/L) within 2 hours of eating.
In GDM, the postprandial blood glucose levels are higher than normal, usually above 140 mg/dL (7.8 mmol/L) within 1 hour or above 120 mg/dL (6.7 mmol/L) within 2 hours of eating.This indicates that the body is not able to use insulin effectively to lower the blood sugar levels after a meal.
C. Elevated serum insulin levels.
This statement is false.
Serum insulin levels are the levels of insulin in the blood.
Insulin is a hormone that helps the cells to take up glucose from the blood for energy or storage.
Normal serum insulin levels vary depending on the time of day, the type of food eaten, and other factors.
In GDM, the serum insulin levels are not necessarily elevated, but they may be insufficient to overcome the insulin resistance caused by hormonal changes during pregnancy.Insulin resistance is a condition where the cells do not respond well to insulin and require more insulin to lower the blood sugar levels.
D. Decreased glycosylated hemoglobin levels.
This statement is false.
Glycosylated hemoglobin (HbA1c) is a measure of how much glucose is attached to hemoglobin, a protein in red blood cells that carries oxygen.
HbA1c reflects the average blood sugar levels over the past 2 to 3 months.
Normal HbA1c levels are below 5.7%.
In GDM, the HbA1c levels are not necessarily decreased, but they may be within or slightly above the normal range, depending on how well the blood sugar levels are controlled during pregnancy.HbA1c is not a reliable test for diagnosing GDM, as it may not reflect the recent changes in blood sugar levels caused by pregnancy.
A nurse is explaining the role of insulin in glucose metabolism to a pregnant woman who has gestational diabetes.
The nurse should tell the woman that insulin is a hormone that does which of the following?
Explanation
The correct answer is
C. It transports glucose from the bloodstream into the cells for energy production.
Insulin is a hormone that regulates the metabolism of carbohydrates, fats, and proteins.It promotes the absorption of glucose from the blood into cells, where it can be used for energy or stored as glycogen or fat.It also inhibits glucose production and secretion by the liver and stimulates lipogenesis and protein synthesis.Insulin is essential for cell metabolism and low insulin levels can cause catabolism of body fat.
A. It converts glucose into glycogen for storage in the liver and muscles.
This statement is partially true, but not the main role of insulin.
Insulin does stimulate the formation of glycogen from glucose in the liver and muscles, but this is not its primary function.Glycogen is a form of stored glucose that can be mobilized when blood glucose levels are low.Insulin also inhibits the breakdown of glycogen (glycogenolysis) and the synthesis of glucose from amino acids and fatty acids (gluconeogenesis) in the liver.
B. It breaks down glucose into carbon dioxide and water for excretion in the urine and lungs.
This statement is false.
Insulin does not break down glucose, but rather facilitates its uptake by cells.
Glucose is broken down by a process called glycolysis, which produces pyruvate and ATP (energy).
Pyruvate can then enter the Krebs cycle and the electron transport chain to produce more ATP, carbon dioxide and water.Carbon dioxide is exhaled by the lungs and water is excreted by the kidneys.
Insulin has no direct role in these processes.
D. It stimulates glucose synthesis from amino acids and fatty acids in the liver.
This statement is false.
Insulin does not stimulate glucose synthesis, but rather inhibits it.
Glucose synthesis from non-carbohydrate sources, such as amino acids and fatty acids, is called gluconeogenesis.
This process occurs mainly in the liver and is stimulated by glucagon, a hormone that opposes insulin.Gluconeogenesis helps to maintain blood glucose levels when dietary intake or glycogen stores are low.Insulin suppresses gluconeogenesis by inhibiting the enzymes involved in this pathway.
A nurse is assessing a pregnant woman who has gestational diabetes for possible complications.
The nurse should monitor the woman for which of the following signs and symptoms?
Explanation
The correct answer is
A. Polyuria, polydipsia, and polyphagia.
These are the classic signs and symptoms of diabetes, which occur due to high blood sugar levels.Gestational diabetes is a type of diabetes that develops during pregnancy and can affect the health of the mother and the baby.
B. Hypotension, bradycardia, and bradypnea.
Statement is wrong because these are signs of low blood pressure, low heart rate, and low breathing rate, which are not related to gestational diabetes.
C. Nausea, vomiting, and abdominal pain.
Statement is wrong because these are signs of ketoacidosis, a serious complication of diabetes that occurs when the body breaks down fat for energy and produces ketones.Ketoacidosis is rare in gestational diabetes and usually affects people with type 1 diabetes.
D. Headache, blurred vision, and drowsiness.
Statement is wrong because these are signs of hyperglycemia (high blood sugar) or hypertensive disorders (high blood pressure), which can occur in gestational diabetes but are not specific to it.They can also be caused by other conditions such as dehydration, infection, or preeclampsia.
Normal ranges for blood sugar levels during pregnancy are:
• Before meals: 3.5 to 5.9 mmol/L (63 to 106 mg/dL)
• One hour after meals: 7.8 mmol/L (140 mg/dL) or less
• Two hours after meals: 6.4 mmol/L (115 mg/dL) or less
A nurse is providing dietary education to a pregnant woman who has gestational diabetes.
Which of the following instructions should the nurse include?
Explanation
The correct answer is choice C. Choose foods that are high in fiber and low in fat.
This instruction will help the client control blood glucose levels and prevent constipation, which is common in pregnancy.
Foods high in fiber include fruits, vegetables, whole grains, beans, nuts, and seeds.
Foods low in fat include lean meats, poultry, fish, low-fat dairy products, and vegetable oils.
Choice A is wrong because eating three large meals per day with snacks in between can cause spikes and drops in blood glucose levels.
The client should eat smaller, more frequent meals throughout the day to maintain a steady blood glucose level.
Choice B is wrong because limiting carbohydrate intake to less than 40% of total calories can lead to ketosis, which is harmful for the fetus.
The client should consume about 45% to 65% of total calories from carbohydrates, preferably from complex sources such as whole grains, fruits, and vegetables.
Choice D is wrong because avoiding foods that contain artificial sweeteners is not necessary for gestational diabetes.
Artificial sweeteners do not affect blood glucose levels and can be used in moderation as part of a balanced diet.
However, the client should limit foods and beverages that are high in sugar and calories, such as soda, candy, cake, and ice cream.
A nurse is preparing to administer insulin to a pregnant woman who has gestational diabetes.
Which of the following types of insulin should the nurse use?
Explanation
The correct answer is choice D. Lispro insulin.
Lispro insulin is a rapid-acting insulin that can be injected 15 minutes before a meal to lower blood sugar.It is safe and effective for pregnant women with gestational diabetes.
Choice A is wrong because regular insulin is a short-acting insulin that needs to be injected 30 minutes before a meal.It may not provide enough control over blood sugar levels during pregnancy.
Choice B is wrong because NPH insulin is an intermediate-acting insulin that has a peak effect several hours after injection.It may cause low blood sugar (hypoglycemia) or high blood sugar (hyperglycemia) if not timed correctly with meals and snacks.
Choice C is wrong because glargine insulin is a long-acting insulin that provides a steady level of insulin throughout the day.
It cannot be mixed with other types of insulin
A nurse is evaluating the blood glucose levels of a pregnant woman who has gestational diabetes after a glucose tolerance test.
Which of the following results indicates that the woman has impaired glucose tolerance?
Explanation
The correct answer is choice B. One-hour blood glucose level of 185 mg/dL.
This indicates that the woman has impaired glucose tolerance, which is a risk factor for gestational diabetes.According to Mayo Clinic, a normal blood glucose level is lower than 140 mg/dL (7.8 mmol/L) after a glucose tolerance test.
A blood glucose level between 140 and 199 mg/dL (7.8 and 11 mmol/L) is considered impaired glucose tolerance,
A nurse is caring for a newborn whose mother has gestational diabetes.
The nurse should monitor the newborn for which of the following complications?
Explanation
Polycythemia is a condition where the baby has too many red blood cells, which can cause blood clots and other problems.It can occur in newborns whose mothers have gestational diabetes because of the high blood sugar levels in the mother’s blood.
Choice A is wrong because macrosomia is not a complication, but a risk factor for gestational diabetes.Macrosomia means having a large baby, which can cause difficulties during delivery and increase the need for a C-section.
Choice B is wrong because hypothermia is not a common complication of gestational diabetes.
Hypothermia means having a low body temperature, which can occur in newborns for various reasons, such as infection, prematurity, or exposure to cold.
Choice D is wrong because hyperglycemia is not a complication of gestational diabetes, but a cause of it.
Hyperglycemia means having high
A nurse is teaching a pregnant woman who has gestational diabetes about how to prevent type 2 diabetes in the future.
Which of the following statements by the woman indicates an understanding of the teaching?
Explanation
A nurse is teaching a pregnant woman who has gestational diabetes about how to prevent type 2 diabetes in the future.
Which of the following statements by the woman indicates an understanding of the teaching?.
A. “I should have my blood glucose levels checked every year.”.
B. “I should avoid breastfeeding my baby.”.
C. “I should gain weight gradually after delivery.”.
D. “I should take oral antidiabetic drugs as prescribed.
Answer and explanation..
The correct answer is choice A.“I should have my blood glucose levels checked every year.” This statement indicates that the woman understands that she is at high risk of developing type 2 diabetes after having gestational diabetes and that regular screening can help detect it early and prevent complications.
Choice B is wrong because breastfeeding can actually lower the risk of type 2 diabetes in women who had gestational diabetes.Breastfeeding can also benefit the baby by reducing the risk of obesity and diabetes later in life.
Choice C is wrong because gaining weight gradually after delivery can increase the risk of type 2 diabetes in women who had gestational diabetes.
Losing excess weight and
A nurse is providing education to a pregnant client who is 42 years old.
The nurse explains that advanced maternal age increases the risk of which condition during pregnancy?