A nurse is caring for a client who is pregnant.
Which of the following provider prescriptions should the nurse plan to implement? Select the 3 actions 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.
Tell the client to refrain from exercise until after delivery.
Correct Answer : A,C,D
A. Encourage the client to limit carbohydrate intake to 40% of their daily calories. This can help manage blood glucose levels more effectively, especially considering the client's history of delivering large newborns and family history of diabetes.
C. Anticipate a prescription for metformin. Metformin is commonly prescribed to manage blood glucose levels in gestational diabetes and may be considered by the healthcare provider due to the client's elevated blood glucose and HbA1c levels.
D. Conduct a non-stress test twice per week. This test monitors the fetal heart rate and provides information about the baby's health, which is crucial given the mother's high BMI and poorly controlled blood glucose levels.
B. The client should check their blood glucose three to four times a day instead of once daily.
E. Regular exercise is beneficial for managing blood glucose levels in pregnancy, especially for clients with diabetes. Exercise helps improve insulin sensitivity and can aid in controlling weight gain and reducing the risk of complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. After childbirth, the uterus begins a process called involution, where it returns to its pre-pregnancy size and position. Approximately 12 hours postpartum, the fundus of the uterus is typically at the level of the umbilicus and should feel firm upon palpation.
A. This finding suggests that the uterus is beginning to involute (shrink back to its pre-pregnancy size). The fundus is expected to gradually descend as involution progresses. However, 12 hours postpartum, the fundus is usually higher than this position.
B. This finding is not within the normal range for 12 hours postpartum. The uterus typically remains at the level of the umbilicus and is soft due to ongoing involution. Softness indicates that the uterus is not well contracted which is not a normal finding.
C. This position is less typical for 12 hours postpartum. The fundus should generally be more centralized and slightly higher than this location as it undergoes involution.
Correct Answer is B
Explanation
B. Massage can stimulate large-diameter nerve fibers that carry non-painful sensations (such as touch and pressure). Activation of these fibers can help close the gate, reducing the transmission of painful stimuli from smaller pain fibers. Therefore, massaging the client's back aligns with the Gate Control Theory by modulating sensory input to the spinal cord.
A. This action can help distract the client from pain and reduce anxiety, which can potentially close the "gate" and decrease the perception of pain. By promoting relaxation and rest, the nurse may indirectly influence the gating mechanism to inhibit pain signals.
C. Positioning the client can be beneficial during labor for various reasons, such as improving blood flow and easing the labor process. While specific lateral positioning (like the left side) may not directly relate to the Gate Control Theory, it can contribute to overall comfort and relaxation, which can influence pain perception indirectly.
D. While analgesic medication can effectively relieve pain, it operates primarily through chemical modulation of pain receptors and pathways in the nervous system. It does not directly interact with the gate mechanism described by the Gate Control Theory. However, by reducing the intensity of pain signals reaching the brain, it can still alleviate pain experienced by the client.
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