A nurse is interpreting the results of a glucose tolerance test for a pregnant woman who was screened for gestational diabetes.

The nurse should recognize that the woman has gestational diabetes if her blood glucose level is which of the following at 1 hour after drinking the sugary drink?

The correct answer is choiceD.

No history of endocrine disorders.This factor increases the client’s risk of developing gestational diabetes because endocrine disorders such as thyroid disease or polycystic ovary syndrome can affect insulin resistance and glucose metabolism.

Choice A is wrong because having a previous baby withlow birth weightis not a risk factor for gestational diabetes.In fact, having a previous baby withhigh birth weight(> 9 pounds) is a risk factor.

Choice B is wrong because being ofCaucasian originis not a risk factor for gestational diabetes.In fact, being ofnon-Caucasian originsuch as African American, Hispanic, Native American, Asian American, or Pacific Islander is a risk factor.

Choice C is wrong because havingno family history of diabetesis not a risk factor for gestational diabetes.In fact, having afamily history of diabetes(especially type 2 diabetes) in a first-degree relative (parent or sibling) is a risk factor.

Some other risk factors for gestational diabetes include being older than 25 years, being overweight or obese, having prediabetes or impaired glucose tolerance, having a history of gestational diabetes in a previous pregnancy, having hypertension or preeclampsia, or having polycystic ovary syndrome.

Normal ranges for fasting plasma glucose are 60 to 99 mg/dL for nonpregnant women and 70 to 95 mg/dL for pregnant women.Normal ranges for oral glucose tolerance test are less than 140 mg/dL at 1 hour and less than 120 mg/dL at 2 hours for nonpregnant women and less than 180 mg/dL at 1 hour and less than 155 mg/dL at 2 hours for pregnant women.

The correct answer is choice C. Choose foods that are high in fiber and low in fat.

This instruction will help the client control blood glucose levels and prevent constipation, which is common in pregnancy.

Foods high in fiber include fruits, vegetables, whole grains, beans, nuts, and seeds.

Foods low in fat include lean meats, poultry, fish, low-fat dairy products, and vegetable oils.

Choice A is wrong because eating three large meals per day with snacks in between can cause spikes and drops in blood glucose levels.

The client should eat smaller, more frequent meals throughout the day to maintain a steady blood glucose level.

Choice B is wrong because limiting carbohydrate intake to less than 40% of total calories can lead to ketosis, which is harmful for the fetus.

The client should consume about 45% to 65% of total calories from carbohydrates, preferably from complex sources such as whole grains, fruits, and vegetables.

Choice D is wrong because avoiding foods that contain artificial sweeteners is not necessary for gestational diabetes.

Artificial sweeteners do not affect blood glucose levels and can be used in moderation as part of a balanced diet.

However, the client should limit foods and beverages that are high in sugar and calories, such as soda, candy, cake, and ice cream.