A nurse is evaluating the effectiveness of nursing interventions for a pregnant woman who has gestational diabetes and received nutritional therapy and exercise counseling during pregnancy.
Which of the following outcomes indicates that the interventions were successful?
The woman gained less than 10 kg (22 lb) during pregnancy
The woman delivered a baby who weighed 3 kg (6.6 lb) at birth
The woman had no episodes of hypoglycemia or hyperglycemia during pregnancy
The woman’s blood glucose levels returned to normal within six weeks after delivery
The Correct Answer is C
The correct answer is choice C. The woman had no episodes of hypoglycemia or hyperglycemia during pregnancy. This indicates that the interventions were successful in maintaining normal blood glucose levels and preventing complications for the mother and the baby.
Choice A is wrong because the woman gained less than 10 kg (22 lb) during pregnancy.
This is below the recommended weight gain range for women with gestational diabetes, which depends on their pre-pregnancy body mass index (BMI). According to a study based on over 12 thousand participants, the ideal weight gain range for women with gestational diabetes was 10–15.9 kg for underweight, 8–11.9 kg for normal weight, 6–7.9 kg for overweight, and -5–3.9 kg for obesity.
Choice B is wrong because the woman delivered a baby who weighed 3 kg (6.6 lb) at birth.
This is within the normal range for birth weight, but it does not necessarily reflect the effectiveness of the interventions for gestational diabetes. A baby born to a mother with gestational diabetes may be at risk of being large for gestational age (LGA), which is defined as a birth weight above the 90th percentile for gestational age. LGA babies may have complications such as shoulder dystocia, hypoglycemia, and respiratory distress syndrome.
Choice D is wrong because the woman’s blood glucose levels returned to normal within six weeks after delivery.
This is a desirable outcome, but it does not indicate that the interventions were successful during pregnancy.
Gestational diabetes usually
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Correct Answer is D
Explanation
The correct answer is choice D. Gestational diabetes.
Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy.
It can cause complications for both the mother and the baby, such as preeclampsia, macrosomia, and neonatal hypoglycemia.An elevated BMI increases the risk of developing gestational diabetes because excess body fat can impair insulin sensitivity and secretion.
Choice A is wrong because preterm labor is not directly related to BMI, but rather to other factors such as infections, cervical insufficiency, or multiple gestation.
Choice B is wrong because ectopic pregnancy is not associated with BMI, but rather with pelvic inflammatory disease, tubal surgery, or previous ectopic pregnancy.
Choice C is wrong because gestational hypertension is not caused by BMI alone, but rather by genetic factors, chronic hypertension, or renal disease.
Normal ranges for BMI are 18.5-24.9 kg/m2 for normal weight, 25.0-29.9 kg/m2 for overweight, and 30.0 kg/m2 or higher for obesity.
Correct Answer is C
Explanation
The correct answer is choice C. The woman had no episodes of hypoglycemia or hyperglycemia during pregnancy.
This outcome indicates that the interventions were successful in maintaining a normal blood glucose level for the woman and preventing complications for her and her baby.
Choice A is wrong because the recommended weight gain for a pregnant woman with gestational diabetes is 11.5 to 16 kg (25 to 35 lb).
Gaining less than 10 kg (22 lb) may indicate inadequate nutrition or poor glycemic control.
Choice B is wrong because the ideal birth weight for a baby of a woman with gestational diabetes is between 2.5 and 4 kg (5.5 and 8.8 lb).
A baby who weighs 3 kg (6.6 lb) at birth is within the normal range, but it does not necessarily reflect the effectiveness of the interventions.
Choice D is wrong because the woman’s blood glucose levels may or may not return to normal within six weeks after delivery.
Gestational diabetes usually resolves after giving birth, but some women may develop type 2 diabetes later in life.
Therefore, a postpartum glucose test is recommended to check the woman’s status.
Normal ranges for blood glucose levels during pregnancy are:
• Fasting: less than 95 mg/dL
• One hour after meals: less than 140 mg/dL
• Two hours after meals: less than 120 mg/dL
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