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. Fetal distress.According to the search results, maternal hyperglycemia during labor is highly associated with macrosomia in neonates, which can lead to fetal distress due to shoulder dystocia, birth trauma, or hypoxia.
Fetal distress can be detected by abnormal fetal heart rate patterns or meconium-stained amniotic fluid.
Choice B. Uterine atony is wrong because it is not a direct complication of hyperglycemia during labor.
Uterine atony is a failure of the uterus to contract after delivery, which can cause postpartum hemorrhage.
It can be caused by multiple factors such as prolonged labor, overdistension of the uterus, infection, or medications.
Choice C. Maternal hypothermia is wrong because it is not a common complication of hyperglycemia during labor.
Maternal hypothermia can occur due to exposure to cold environment, anesthesia, or infection.
It can affect the maternal and fetal metabolism and oxygenation.
Choice D. Placental abruption is wrong because it is not a direct complication of hyperglycemia during labor.
Placental abruption is a premature separation of the placenta from the uterine wall, which can cause fetal and maternal hemorrhage, hypoxia, and shock.
It can be caused by trauma, hypertension, smoking, or cocaine use.
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 goal of intrapartum insulin therapy is maternal and fetal euglycemia with a maternal glucose less than 90 mg/dL.Hourly blood glucose monitoring can help adjust the insulin infusion rate and prevent hypoglycemia or hyperglycemia.
Choice B is wrong because every two hours is not frequent enough to maintain optimal glucose control during labor.
Choice C is wrong because every four hours is too long to wait between blood glucose checks and could lead to complications.
Choice D is wrong because every six hours is even longer and more risky than choice C. Normal ranges for blood glucose levels during labor are between 4.0 and 6.0-7.0 mmol/L (72-108 mg/dL).Women with gestational diabetes who require less than 1.0 units/kg/d of insulin may not need intravenous insulin, but they still need to be monitored regularly.
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