A nurse is evaluating the outcomes of care for a pregnant woman who has gestational diabetes and received insulin therapy during pregnancy.

Which of the following findings indicates that the insulin therapy was effective?

The woman had normal blood pressure and urine protein levels throughout pregnancy

The woman delivered a healthy 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.

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. The woman delivered a healthy baby who weighed 3 kg (6.6 lb) at birth. This indicates that the insulin therapy was effective in preventing macrosomia, which is a common complication of gestational diabetes mellitus (GDM) . Macrosomia is defined as a birth weight above the 90th percentile for gestational age or above 4 kg (8.8 lb) . Macrosomia increases the risk of birth trauma, shoulder dystocia, cesarean section, and neonatal hypoglycemia .

Choice A is wrong because normal blood pressure and urine protein levels throughout pregnancy are not specific indicators of insulin therapy effectiveness. They are more related to the prevention of pre-eclampsia, which is a separate complication of pregnancy that can affect women with or without GDM .

Choice C is wrong because having no episodes of hypoglycemia or hyperglycemia during pregnancy is not sufficient to indicate insulin therapy

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Correct Answer is B

Explanation

The correct answer is choice B. Preeclampsia.

Preeclampsia is a complication of pregnancy that is characterized by high blood pressure, proteinuria, and edema.It can result from uncontrolled blood sugar levels, as well as other risk factors such as obesity, hypertension, and previous large for gestational age (LGA) infant.

Preeclampsia can lead to serious complications for both the mother and the baby, such as eclampsia, HELLP syndrome, placental abruption, and intrauterine growth restriction.

Choice A. Placenta previa is wrong because it is a condition where the placenta covers the cervix partially or completely.It is not caused by uncontrolled blood sugar levels, but by factors such as previous cesarean section, multiple gestation, advanced maternal age, and smoking.

Choice C. Chorioamnionitis is wrong because it is an infection of the amniotic fluid and membranes that surround the fetus.

It is not caused by uncontrolled blood sugar levels, but by bacteria that ascend from the vagina or cervix into the uterus.It can cause fever, uterine tenderness, foul-smelling amniotic fluid, and fetal tachycardia.

Choice D. Abruptio placentae is wrong because it is a condition where the placenta separates from the uterine wall before delivery.It is not caused by uncontrolled blood sugar levels, but by factors such as trauma, hypertension, smoking, cocaine use, and previous history of abruption.

A. Every hour B. Every two hours C. Every four hours D. Every six hours

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 the maternal glucose level should be maintained between 4.0 and 6.0-7.0 mmol/L during labor to prevent neonatal hypoglycemia.

Choice B is wrong because monitoring every two hours may not be frequent enough to detect and correct any fluctuations in blood glucose levels.

Choice C is wrong because monitoring every four hours is too infrequent and may increase the risk of complications for the mother and the baby.

Choice D is wrong because monitoring every six hours is even more infrequent and may lead to poor outcomes.

Normal ranges for blood glucose levels during pregnancy are:

• Fasting or preprandial: < 95 mg/dL

• Postprandial (1 hour): < 140 mg/dL

• Postprandial (2 hours): < 120 mg/dL

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A nurse is evaluating the outcomes of care for a pregnant woman who has gestational diabetes and received insulin therapy during pregnancy. Which of the following findings indicates that the insulin therapy was effective?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a pregnant woman who has gestational diabetes and is in labor. The nurse should monitor the woman for which of the following complications that can result from uncontrolled blood sugar levels?

Correct Answer is B

Explanation

A nurse is caring for a pregnant woman who has gestational diabetes and is in labor. The nurse should monitor the woman’s blood glucose levels every how often during labor?

Correct Answer is A

Explanation

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A nurse is evaluating the outcomes of care for a pregnant woman who has gestational diabetes and received insulin therapy during pregnancy.

Which of the following findings indicates that the insulin therapy was effective?