A nurse is assessing a pregnant client's medical history.

Which factor increases the client's risk of developing gestational diabetes?

Having a previous baby with low birth weight

Being of Caucasian origin

No family history of diabetes

No history of endocrine disorders

Answer and Explanation

The Correct Answer is D

The correct answer is choice D.

No history of endocrine disorders. This factor increases the client’s risk of developing gestational diabetes because endocrine disorders such as thyroid disease or polycystic ovary syndrome can affect insulin resistance and glucose metabolism.

Choice A is wrong because having a previous baby with low birth weight is not a risk factor for gestational diabetes. In fact, having a previous baby with high birth weight (> 9 pounds) is a risk factor.

Choice B is wrong because being of Caucasian origin is not a risk factor for gestational diabetes. In fact, being of non-Caucasian origin such as African American, Hispanic, Native American, Asian American, or Pacific Islander is a risk factor.

Choice C is wrong because having no family history of diabetes is not a risk factor for gestational diabetes. In fact, having a family history of diabetes (especially type 2 diabetes) in a first-degree relative (parent or sibling) is a risk factor.

Some other risk factors for gestational diabetes include being older than 25 years, being overweight or obese, having prediabetes or impaired glucose tolerance, having a history of gestational diabetes in a previous pregnancy, having hypertension or preeclampsia, or having polycystic ovary syndrome.

Normal ranges for fasting plasma glucose are 60 to 99 mg/dL for nonpregnant women and 70 to 95 mg/dL for pregnant women. Normal ranges for oral glucose tolerance test are less than 140 mg/dL at 1 hour and less than 120 mg/dL at 2 hours for nonpregnant women and less than 180 mg/dL at 1 hour and less than 155 mg/dL at 2 hours for pregnant women.

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Correct Answer is A

Explanation

The correct answer is choice A. A 32-year-old woman who is obese and has PCOS.

This woman has two major risk factors for developing gestational diabetes: obesity and polycystic ovary syndrome (PCOS).Obesity increases insulin resistance and PCOS is associated with hormonal imbalances that affect glucose metabolism.

Choice B is wrong because being Asian and having a previous baby who weighed 4 kg (8.8 lb) at birth are not as strong risk factors as obesity and PCOS.However, they do increase the risk slightly.

Choice C is wrong because being Caucasian and having impaired glucose tolerance are also not as strong risk factors as obesity and PCOS.Impaired glucose tolerance means that the blood sugar level is higher than normal but not high enough to be diagnosed as diabetes.

Choice D is wrong because being Hispanic and having a parent with type 2 diabetes are also not as strong risk factors as obesity and PCOS.However, they do increase the risk slightly.

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. One hour B. Two hours C. Three hours D. Four hours

Correct Answer is A

Explanation

The correct answer is choice A. The nurse should check the newborn’s blood glucose level within one hour after birth.This is because newborns of mothers with gestational diabetes are at risk of developing hypoglycemia due to hyperinsulinemia.Hypoglycemia can cause neurological damage or death if not treated promptly.

Choice B is wrong because two hours may be too late to detect and treat hypoglycemia in a newborn at risk.

Choice C is wrong because three hours is definitely too late to check the blood glucose level of a newborn at risk of hypoglycemia.

Choice D is wrong because four hours is way too late to check the blood glucose level of a newborn at risk of hypoglycemia.

The normal blood glucose level for a newborn is between 70 and 150 mg/dL.However, some infants may have transient low blood glucose levels as low as 25 mg/dL within the first two hours of life, which is physiologic and self-limited.Infants with risk factors for hypoglycemia, such as maternal diabetes, should be screened at 2 hours of age and then before each feeding for the first and second days of life.A blood glucose level of less than 45 mg/dL in an asymptomatic infant or less than 36 mg/dL in a symptomatic infant is considered hypoglycemic and requires treatment.

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A nurse is assessing a pregnant client's medical history. Which factor increases the client's risk of developing gestational diabetes?

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical records of four pregnant women who are being screened for gestational diabetes. Which of the following women has the highest risk factor for developing gestational diabetes?

Correct Answer is A

Explanation

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?

Correct Answer is A

Explanation

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A nurse is assessing a pregnant client's medical history.

Which factor increases the client's risk of developing gestational diabetes?