A nurse is assessing a newborn whose mother has gestational diabetes for signs of hypoglycemia.
The nurse should check the newborn’s blood glucose level within how many hours after birth?
One hour
Two hours
Three hours
Four hours
The Correct Answer is A
The correct answer is choice A. The nurse should check the newborn’s blood glucose level within one hour after birth. This is because infants born to mothers with gestational diabetes are at risk of developing hypoglycemia due to increased insulin secretion in response to maternal-fetal hyperglycemia. Hypoglycemia can cause neurological damage and other complications in newborns, so early detection and treatment are essential.
Choice B is wrong because two hours after birth may be too late to prevent or treat hypoglycemia in some infants.
Choice C is wrong because three hours after birth is even later and may increase the risk of adverse outcomes.
Choice D is wrong because four hours after birth is the latest time to check the blood glucose level and may miss some cases of hypoglycemia that occur earlier.
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Correct Answer is B
Explanation
The correct answer is choice B. The woman delivered a healthy baby who weighed 3 kg (6.6 lb) at birth.This indicates that the insulin therapy was effective in preventing macrosomia, which is a common complication of gestational diabetes mellitus (GDM).Macrosomia is defined as a birth weight above the 90th percentile for gestational age or above 4 kg (8.8 lb).Macrosomia increases the risk of birth trauma, shoulder dystocia, cesarean section, and neonatal hypoglycemia.
Choice A is wrong because normal blood pressure and urine protein levels throughout pregnancy are not specific indicators of insulin therapy effectiveness.They are more related to the prevention of pre-eclampsia, which is a separate complication of pregnancy that can affect women with or without GDM.
Choice C is wrong because having no episodes of hypoglycemia or hyperglycemia during pregnancy is not sufficient to indicate insulin therapy
Correct Answer is A
Explanation
The correct answer is choice A. The nurse should monitor the woman’s blood glucose levels every hour during labor.This is because labor is a stressful event that can increase the blood glucose levels and the risk of complications for both the mother and the baby.The goal is to maintain the maternal glucose between 4.0 and 6.0-7.0 mmol/L during labor.
Choice B is wrong because every two hours is too infrequent to detect and correct any fluctuations in blood glucose levels during labor.
Choice C is wrong because every four hours is even more infrequent and could lead to poor glucose control and adverse outcomes.
Choice D is wrong because every six hours is the least frequent and the most dangerous option for monitoring blood glucose levels during labor.
Normal ranges for blood glucose levels are 3.9 to 5.5 mmol/L for fasting or preprandial values, and less than 7.8 mmol/L for postprandial values.
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