A client with type 1 diabetes mellitus is seeking preconception counseling.
She has a high glycosylated hemoglobin (HgbA1c). Before trying to become pregnant, she is strongly encouraged to stabilize her blood glucose to reduce the possibility of her baby developing which of the following?

Choice A rationale

A 1-hour post-prandial value of 110 mg/dL is within the normal range and does not indicate gestational diabetes.

Choice B rationale

A 3-hour glucose tolerance test fasting value of 80 mg/dL is normal and does not alone indicate gestational diabetes.

Choice C rationale

A glucose challenge test-fasting value of 100 mg/dL and a 2-hour value of 130 mg/dL do not meet the criteria for gestational diabetes diagnosis.

Choice D rationale

A 3-hour glucose tolerance test-fasting value of 98 mg/dL and a 3-hour value of 190 mg/dL indicate gestational diabetes due to elevated glucose levels.

Choice A rationale

Observing the perineum for signs of crowning is important, but it doesn’t address the immediate need to manage the client’s urge to push. By the time crowning is visible, delivery is imminent, and the urge to push should have been managed earlier.

Choice B rationale

Helping the client to the bathroom to void might relieve some pressure but is not the immediate priority when the client feels the urge to push. Voiding can wait until contractions are managed.

Choice C rationale

Assisting the client into a supine position is not ideal for managing the urge to push. A supine position can increase discomfort and does not facilitate optimal delivery dynamics.

Choice D rationale

Assisting the client with quick shallow breathing helps manage the urge to push and prevents premature pushing, reducing the risk of cervical injury and aiding controlled delivery.