A nurse is reinforcing teaching with a client who is in her second trimester and has a new diagnosis of gestational diabetes. Which of the following statements by the client indicates a need for further teaching?
"I should limit my carbohydrates to 50% of my daily caloric intake."
"I know I am at increased risk to develop type 2 diabetes."
"I will reduce my exercise schedule to 3 days a week."
"I will take my glyburide daily with breakfast."
The Correct Answer is C
c. "I will reduce my exercise schedule to 3 days a week."
The client should not reduce her exercise schedule, as physical activity can help lower blood glucose levels and improve insulin sensitivity in gestational diabetes. The client should aim for at least 30 minutes of moderate-intensity exercise on most days of the week unless contraindicated by her provider. Exercise can also help prevent excessive weight gain, preeclampsia, and macrosomia in pregnancy.
The other statements are correct and do not indicate a need for further teaching.
The client should limit her carbohydrates to 50% of her daily caloric intake, as carbohydrates have the most impact on blood glucose levels. The client should also choose complex carbohydrates that are high in fiber and low in glycemic index, such as whole grains, fruits, and vegetables. The client should know that she is at increased risk of developing type 2 diabetes, as gestational diabetes is a risk factor for future diabetes mellitus. The client should undergo screening for diabetes 6 to 12 weeks after delivery and every 1 to 3 years thereafter. The client should also adopt lifestyle modifications such as a healthy diet, regular exercise, and weight management to prevent or delay the onset of type 2 diabetes. The client should take her glyburide daily with breakfast, as glyburide is an oral antidiabetic agent that can be used to treat gestational diabetes when diet and exercise are not enough to control blood glucose levels. Glyburide stimulates the pancreas to produce more insulin and lowers blood glucose levels. Glyburide should be taken with the first meal of the day to avoid hypoglycemia.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Maternal battering or abdominal trauma is a significant cause of placental abruption, but it is not the most frequent. Trauma accounts for a smaller percentage of cases compared to chronic vascular conditions. While it requires immediate screening, it is categorized as an acute mechanical trigger rather than the primary underlying systemic risk factor.
Choice B reason: Cigarette smoking increases the risk of placental abruption due to vasoconstriction and placental hypoperfusion. While smoking is a modifiable risk factor associated with various adverse pregnancy outcomes, research cited by the NIH indicates it is less prevalent as a primary cause compared to the high incidence of hypertensive disorders in pregnancy.
Choice C reason: Maternal hypertension, whether chronic or pregnancy-induced (preeclampsia), is the most common risk factor for placental abruption. High blood pressure causes vascular changes and vasospasms that lead to reduced blood flow and potential separation of the placenta from the uterine wall. This is a leading cause in clinical textbooks.
Choice D reason: Maternal cocaine use is a known risk factor because it causes sudden, severe vasoconstriction and sharp increases in blood pressure. Although this can lead to catastrophic placental separation, the overall frequency of cocaine-induced abruption in the general population is lower than that caused by the widespread prevalence of hypertensive disorders.
Correct Answer is C
No explanation
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