A nurse is providing education to a pregnant client who is 42 years old.

The nurse explains that advanced maternal age increases the risk of which condition during pregnancy?

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. The nurse should instruct the client to rotate injection sites to ensure consistent insulin absorption.Rotating injection sites helps prevent lipodystrophy, which is a condition that affects the subcutaneous fat tissue and can impair insulin absorption.

Choice A is wrong because injecting insulin directly into the umbilical area is not recommended for pregnant clients, as it may cause irritation or infection of the umbilical cord.

Choice B is wrong because needles should be disposed of in a puncture-resistant container, not in a regular trash bin, to prevent needlestick injuries.

Choice D is wrong because insulin vials should be stored in the refrigerator, not in the freezer, to maintain potency.Freezing can damage the insulin molecules and reduce their effectiveness.