A nurse is caring for a client who is pregnant.
Exhibits
Select the 3 actions that the nurse should plan to take
Encourage the client to limit carbohydrate intake to 40% of their daily calories.
Instruct the client to check a random blood glucose level once daily
Anticipate a prescription for metformin.
Conduct a non-stress test twice per week.
Correct Answer : A,C,D
A. Encourage the client to limit carbohydrate intake to 40% of their daily calories. For clients with gestational diabetes, dietary modifications are a critical intervention. Limiting carbohydrate intake to 40% of daily calories can help regulate blood glucose levels.
B. Instruct the client to check a random blood glucose level once daily. The client should check fasting and postprandial blood glucose levels regularly (usually multiple times per day) to manage glucose control more effectively.
C. Anticipate a prescription for metformin. Given the elevated fasting blood glucose levels and high HbA1C (12%), this client may require pharmacological management to control blood sugar levels. Metformin is a common oral hypoglycemic agent used during pregnancy when diet and lifestyle changes are insufficient.
D. Conduct a non-stress test twice per week. Clients with uncontrolled gestational diabetes or poorly controlled blood sugar levels are at increased risk of fetal complications such as macrosomia, stillbirth, and preterm labor. A non-stress test (NST) twice a week helps monitor fetal well-being and detect early signs of distress.
E. Tell the client to refrain from exercise until after delivery. Exercise is generally recommended for clients with gestational diabetes unless contraindicated. Regular physical activity can help lower blood glucose levels and improve insulin sensitivity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. A 15-year-old client who has acne: Oral contraceptives are often used to treat acne in adolescents and are not contraindicated in this case.
B. A client who has a menstrual cycle every 14 days: Irregular or frequent menstrual cycles are not a contraindication to oral contraceptive use. In fact, oral contraceptives are sometimes used to regulate menstrual cycles.
C. A client who has a hematocrit of 39% (expected range 37%-47%): A hematocrit of 39% is within the normal range and does not pose a contraindication to oral contraceptive use.
D. A client who has a blood pressure of 146/92 mm Hg: Oral contraceptives can increase blood pressure and are contraindicated in clients with uncontrolled hypertension (above 140/90 mm Hg) due to the risk of thromboembolic events and cardiovascular complications.
Correct Answer is A
Explanation
A. Quickening: Quickening refers to the first movements of the fetus felt by the mother, which often feels like fluttering or light movements. It typically occurs between 16 and 20 weeks of gestation.
B. Chloasma: Chloasma refers to the darkened patches of skin that can appear on the face during pregnancy, also known as the "mask of pregnancy."
C. Lightening: Lightening refers to the descent of the fetus into the pelvis in preparation for birth, which usually occurs in the third trimester, not at 18 weeks of gestation.
D. Ballottement: Ballottement is a technique used during a pelvic examination where the examiner taps on the cervix and feels the fetus bounce back. It is a clinical sign rather than something the mother feels.
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