A nurse is caring for a client who is at 31 weeks of gestation and has gestational diabetes mellitus. The client asks, "Can gestational diabetes affect my baby?" Which of the following responses should the nurse make?

"Gestational diabetes increases the risk of your baby having hemorrhagic disease after birth."

"Gestational diabetes increases the risk of your baby having a cleft lip or palate."

"Gestational diabetes increases the risk of your baby having hypoglycemia after birth."

"Gestational diabetes increases the risk of your baby having a low birth weight."

Answer and Explanation

The Correct Answer is C

A) "Gestational diabetes increases the risk of your baby having hemorrhagic disease after birth." Hemorrhagic disease of the newborn is typically related to vitamin K deficiency, not gestational diabetes. Thus, this response does not directly address the risks associated with gestational diabetes.

B) "Gestational diabetes increases the risk of your baby having a cleft lip or palate." Cleft lip and palate are congenital conditions that are more related to genetic and environmental factors during the early stages of pregnancy. Gestational diabetes does not increase the risk of these specific congenital abnormalities.

C) "Gestational diabetes increases the risk of your baby having hypoglycemia after birth." This is correct. Infants born to mothers with gestational diabetes are at risk for hypoglycemia shortly after birth due to the high levels of insulin produced in response to maternal hyperglycemia during pregnancy.

D) "Gestational diabetes increases the risk of your baby having a low birth weight." Gestational diabetes more commonly leads to macrosomia (large birth weight) rather than low birth weight. The excessive glucose levels in the mother’s blood can result in increased fetal insulin production, leading to increased growth and fat deposits.

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Correct Answer is A

Explanation

A) Cleanse the client's finger with an antiseptic swab: The first step in performing a capillary blood glucose test is to cleanse the client’s finger with an antiseptic swab. This reduces the risk of infection and ensures that any contaminants on the skin do not affect the accuracy of the blood glucose reading.

B) Hold the client's finger in a dependent position: Holding the finger in a dependent position can help increase blood flow, but this step is taken after cleansing the finger. The priority is to first clean the area to minimize the risk of infection.

C) Wipe away the first drop of blood: Wiping away the first drop of blood is done to avoid contamination from interstitial fluid and to ensure a more accurate reading. However, this action occurs after the blood sample is obtained, not before the test begins.

D) Place the lancet on the side of the selected finger: While placing the lancet on the side of the finger is important for minimizing discomfort and obtaining an adequate blood sample, it follows the initial steps of cleaning the finger and preparing for the blood draw.

A. Request return instructions in the client's own words. B. Provide brochures that reflect a seventh-grade reading level. C. Limit teaching materials to written information. D. Avoid repetition of information within each session.

Correct Answer is A

Explanation

A) Request return instructions in the client's own words:
Asking the client to repeat instructions in their own words is an effective strategy for ensuring understanding, especially for individuals with low health literacy. This technique, known as the "teach-back" method, allows the nurse to assess the client’s comprehension and clarify any misunderstandings.

B) Provide brochures that reflect a seventh-grade reading level:
While providing materials at a lower reading level can be helpful, it may not be sufficient for individuals with very low health literacy. It is essential to use multiple strategies, including verbal communication and interactive methods, to ensure understanding.

C) Limit teaching materials to written information:
Relying solely on written information is not advisable for clients with low health literacy. Visual aids, demonstrations, and verbal explanations should be included to enhance comprehension and retention of information.

D) Avoid repetition of information within each session:
Repetition is actually beneficial for clients with low health literacy. Repeating key information helps reinforce learning and ensures that the client retains the essential points discussed during the teaching sessions.

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A nurse is caring for a client who is at 31 weeks of gestation and has gestational diabetes mellitus. The client asks, "Can gestational diabetes affect my baby?" Which of the following responses should the nurse make?

Nursing Test Bank

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