A nurse is assessing a pregnant woman for risk factors for gestational diabetes.

Which of the following factors should the nurse identify as increasing the woman's risk?

The correct answer is choice D. “I should have my baby weighed at every prenatal visit.” This statement indicates a need for further teaching because having the baby weighed at every prenatal visit is not a way to prevent or detect gestational diabetes.Gestational diabetes is a condition in which women develop high blood sugar during pregnancy due to hormonal changes and insufficient insulin production.It can cause complications for the mother and the baby, such as high blood pressure, heavy birth weight, premature delivery, low blood sugar and future diabetes.

Choice A is wrong because losing weight before getting pregnant if one has a high BMI is a good way to reduce the risk of gestational diabetes.Obesity is one of the biggest risk factors for developing gestational diabetes, as it affects the body’s ability to use insulin effectively.

Choice B is wrong because telling the doctor if one has a family history of diabetes is also a good way to reduce the risk of gestational diabetes.Having a parent or sibling with diabetes increases the likelihood of developing gestational diabetes, as it may indicate a genetic predisposition to insulin resistance.

Choice C is wrong because avoiding getting pregnant after 40 years old is another good way to reduce the risk of gestational diabetes.Maternal age is one of the most important independent risk factors for gestational diabetes, as older women tend to have more insulin resistance and less beta-cell function than younger women.

The correct answer is choice A. The woman should check her blood glucose levels four times a day to monitor and manage her condition.This will help her avoid complications such as ketoacidosis, hypoglycemia, or fetal macrosomia.

Choice B is wrong because drinking juice or soda can increase blood glucose levels and worsen hyperglycemia.The woman should drink water or sugar-free beverages if she feels thirsty.

Choice C is wrong because vaginal discharge or itching may indicate a yeast infection, which is more common in women with diabetes, but not a sign of hyperglycemia.The woman should report any signs of infection to her doctor, but also check her blood glucose levels regularly.

Choice D is wrong because stopping insulin or oral medication after delivery can cause blood glucose levels to rise and lead to diabetic ketoacidosis, a life-threatening condition.The woman should consult with her doctor before making any changes to her medication regimen.

Normal ranges for blood glucose levels during pregnancy are:

• Before meals: 60-99 mg/dL

• One hour after meals: 100-129 mg/dL

• Two hours after meals: <120 mg/dL