A nurse is reviewing the laboratory results of a pregnant woman who has gestational diabetes.
The nurse expects to find which of the following findings?
Elevated fasting blood glucose levels
Decreased postprandial blood glucose levels
Elevated serum insulin levels.
Decreased glycosylated hemoglobin levels
The Correct Answer is A
The correct answer is
A. Elevated fasting blood glucose levels.
Gestational diabetes (GDM) is a condition where the blood sugar levels are higher than normal during pregnancy.
It can affect the health of the mother and the baby if not well controlled. GDM usually goes away after delivery, but it can increase the risk of developing type 2 diabetes later in life.
A. Elevated fasting blood glucose levels.
This statement is true.
Fasting blood glucose levels are the levels of glucose in the blood after not eating or drinking anything except water for at least 8 hours.
Normal fasting blood glucose levels are between 70 and 100 mg/dL (3.9 and 5.6 mmol/L).
In GDM, the fasting blood glucose levels are higher than normal, usually above 95 mg/dL (5.3 mmol/L). This indicates that the body is not able to use insulin effectively to lower the blood sugar levels.
B. Decreased postprandial blood glucose levels.
This statement is false.
Postprandial blood glucose levels are the levels of glucose in the blood after eating a meal or a snack.
Normal postprandial blood glucose levels are below 140 mg/dL (7.8 mmol/L) within 2 hours of eating.
In GDM, the postprandial blood glucose levels are higher than normal, usually above 140 mg/dL (7.8 mmol/L) within 1 hour or above 120 mg/dL (6.7 mmol/L) within 2 hours of eating. This indicates that the body is not able to use insulin effectively to lower the blood sugar levels after a meal.
C. Elevated serum insulin levels.
This statement is false.
Serum insulin levels are the levels of insulin in the blood.
Insulin is a hormone that helps the cells to take up glucose from the blood for energy or storage.
Normal serum insulin levels vary depending on the time of day, the type of food eaten, and other factors.
In GDM, the serum insulin levels are not necessarily elevated, but they may be insufficient to overcome the insulin resistance caused by hormonal changes during pregnancy. Insulin resistance is a condition where the cells do not respond well to insulin and require more insulin to lower the blood sugar levels .
D. Decreased glycosylated hemoglobin levels.
This statement is false.
Glycosylated hemoglobin (HbA1c) is a measure of how much glucose is attached to hemoglobin, a protein in red blood cells that carries oxygen.
HbA1c reflects the average blood sugar levels over the past 2 to 3 months.
Normal HbA1c levels are below 5.7%.
In GDM, the HbA1c levels are not necessarily decreased, but they may be within or slightly above the normal range, depending on how well the blood sugar levels are controlled during pregnancy. HbA1c is not a reliable test for diagnosing GDM, as it may not reflect the recent changes in blood sugar levels caused by pregnancy .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice A. One hour.The nurse should check the newborn’s blood glucose level within one hour after birth because infants born to mothers with gestational diabetes are at risk of hypoglycemia due to increased insulin secretion in response to maternal-fetal hyperglycemia.Hypoglycemia can cause symptoms such as jitteriness, lethargy, poor feeding, cyanosis and apnea.
Checking the blood glucose level within one hour can help identify and treat hypoglycemia promptly.
Choice B. Two hours is wrong because it may delay the detection and treatment of hypoglycemia, which can have adverse effects on the newborn’s brain development.
Choice C. Three hours is wrong for the same reason as choice B. Choice D. Four hours is wrong for the same reason as choice B and C. Normal ranges for blood glucose levels in newborns vary depending on the method of measurement, but generally they are above 47 mg/dL.Some sources suggest a lower cutoff of 40 mg/dL.
Correct Answer is D
Explanation
The correct answer is choice D. All of the above.
The nurse should tell the woman to wash her hands with soap and water before testing, prick the side of her fingertip with a lancet, and apply gentle pressure to the puncture site until a drop of blood forms.These steps are necessary to ensure accurate and safe blood glucose monitoring at home.
Choice A is wrong because washing hands with soap and water is not enough.The woman should also dry her hands thoroughly before testing.
Choice B is wrong because pricking the side of the fingertip is not enough.The woman should also rotate the puncture sites to avoid soreness and infection.
Choice C is wrong because applying gentle pressure to the puncture site is not enough.The woman should also dispose of the lancet and the test strip properly and record the blood glucose result.
Normal blood glucose ranges for pregnant women with gestational diabetes are 95 mg/dL or less before meals, 140 mg/dL or less 1 hour after meals, and 120 mg/dL or less 2 hours after meals.
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