A nurse is caring for a newborn whose mother has gestational diabetes.

The nurse should monitor the newborn for which of the following complications?

The correct answer is choice A. The nurse should monitor the woman’s blood glucose levels every hour during labor.This is because maternal blood glucose levels around the time of delivery are directly related to the risk of neonatal hypoglycemia.Therefore, achieving maternal euglycemia in women with gestational diabetes mellitus is critical to decreasing the risk of neonatal complications.

Choice B is wrong because every two hours is not frequent enough to ensure optimal glucose control during labor.

Choice C is wrong because every four hours is even less frequent and may miss significant fluctuations in blood glucose levels.

Choice D is wrong because every six hours is too infrequent and may put the mother and the baby at risk of adverse outcomes.

The maternal glucose should be maintained between 4.0 and 6.0-7.0 mmol/L during labor.Most women with gestational diabetes, especially if they require less than 1.0 units/kg/d of insulin, can simply be monitored without intravenous insulin.However, women who are taking medication for gestational diabetes require more frequent glucose monitoring, typically with hourly evaluations.

The correct answer is choice B. Biophysical profile.

A biophysical profile is a test that combines a nonstress test with an ultrasound to assess the well-being of the fetus.

It measures five parameters: fetal heart rate, fetal breathing movements, fetal body movements, fetal tone, and amniotic fluid volume.A biophysical profile is indicated for pregnant women with gestational diabetes who are taking oral antidiabetic drugs because these medications can cross the placenta and affect the fetal blood glucose levels.

Choice A is wrong because a nonstress test is a test that measures the fetal heart rate response to fetal movements.It is a screening test for fetal well-being, but it does not provide information about the fetal blood glucose levels or the amniotic fluid volume.

Choice C is wrong because an amniocentesis is a test that involves inserting a needle into the uterus to obtain a sample of amniotic fluid for genetic or biochemical analysis.It is not routinely performed for pregnant women with gestational diabetes unless there is a suspicion of a chromosomal abnormality or a fetal infection.

Choice D is wrong because chorionic villus sampling is a test that involves obtaining a sample of placental tissue for genetic or biochemical analysis.

It is usually performed between 10 and 13 weeks of gestation for women who are at high risk of having a baby with a chromosomal abnormality or a genetic disorder.It is not indicated for pregnant women with gestational diabetes who are taking oral antidiabetic drugs.