A nurse is caring for a pregnant woman who has gestational diabetes and is of African-Caribbean origin.
The nurse should recognize that the woman's ethnicity is associated with which of the following characteristics?
Higher insulin resistance
Lower birth weight
Earlier onset of diabetes
Faster resolution of diabetes
The Correct Answer is A
The correct answer is choice A. Higher insulin resistance. According to a systematic review of gestational diabetes mellitus (GDM) in Africa, African-Caribbean women have higher insulin resistance than other ethnic groups, which increases their risk of developing GDM.
Insulin resistance is a condition where the body does not respond well to the hormone insulin, which regulates blood sugar levels.
Choice B is wrong because lower birth weight is not associated with GDM in African-Caribbean women. In fact, some studies have found that GDM increases the risk of macrosomia (large for gestational age infants) and higher mean birth weight.
Choice C is wrong because earlier onset of diabetes is not a characteristic of African-Caribbean women with GDM.
GDM is usually diagnosed in the second or third trimester of pregnancy, regardless of ethnicity. However, women with GDM have a higher risk of developing type 2 diabetes later in life.
Choice D is wrong because faster resolution of diabetes is not a characteristic of African-Caribbean women with GDM. Most women with GDM revert to normal glucose metabolism after delivery, but some may have persistent glucose intolerance or diabetes. The risk of developing type 2 diabetes after GDM is also higher for African-Caribbean women than other ethnic groups.
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Correct Answer is A
Explanation
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.
Correct Answer is B
Explanation
The correct answer is choice B. One-hour blood glucose level of 185 mg/dL.
This indicates that the woman has impaired glucose tolerance, which is a risk factor for gestational diabetes.According to Mayo Clinic, a normal blood glucose level is lower than 140 mg/dL (7.8 mmol/L) after a glucose tolerance test.
A blood glucose level between 140 and 199 mg/dL (7.8 and 11 mmol/L) is considered impaired glucose tolerance,
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