A nurse is reviewing the medical records of four pregnant women who are being screened for gestational diabetes.

Which of the following women has the highest risk factor for developing gestational diabetes?

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.

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 hyperinsulinemia.Hypoglycemia can cause neurologic damage or death if left untreated.

Choice B is wrong because two hours is too long to wait for checking the blood glucose level of a newborn at risk of hypoglycemia.

Choice C is wrong because three hours is too long to wait for checking the blood glucose level of a newborn at risk of hypoglycemia.

Choice D is wrong because four hours is too long to wait for checking the blood glucose level of a newborn at risk of hypoglycemia.

Normal blood glucose levels for newborns are between 47 and 70 mg/dL.Mild hypoglycemia is defined as less than 47 mg/dL and severe hypoglycemia is defined as less than 36 mg/dL.