What are the maternal and neonatal risks associated with gestational diabetes mellitus?
Maternal placenta previa and fetal prematurity.
Maternal hyperemesis and neonatal low birth weight.
Maternal premature rupture of membranes and neonatal sepsis.
Maternal preeclampsia and fetal macrosomia.
The Correct Answer is D
Choice A reason: Maternal placenta previa is not a common complication of gestational diabetes mellitus. Placenta previa is a condition in which the placenta covers the cervix, which can cause bleeding and preterm labor. The risk factors for placenta previa include previous cesarean delivery, multiple pregnancy, advanced maternal age, and smoking.
Choice B reason: Maternal hyperemesis and neonatal low birth weight are not directly related to gestational diabetes mellitus. Hyperemesis is a severe form of nausea and vomiting during pregnancy that can cause dehydration and weight loss. The causes of hyperemesis are not well understood, but it may be influenced by hormonal changes, genetic factors, and psychological factors². Neonatal low birth weight is defined as a birth weight of less than 2,500 grams, which can be caused by many factors, such as prematurity, intrauterine growth restriction, maternal infection, and maternal malnutrition.
Choice C reason: Maternal premature rupture of membranes and neonatal sepsis are not specific to gestational diabetes mellitus. Premature rupture of membranes is a condition in which the amniotic sac breaks before labor begins, which can increase the risk of infection and preterm delivery. The causes of premature rupture of membranes are not clear, but some possible factors include infection, inflammation, stress, and trauma. Neonatal sepsis is a life-threatening infection in newborns, which can be caused by bacteria, viruses, or fungi. The risk factors for neonatal sepsis include prematurity, low birth weight, maternal infection, and invasive procedures⁵.
Choice D reason: Maternal preeclampsia and fetal macrosomia are the most common and serious complications of gestational diabetes mellitus. Preeclampsia is a condition characterized by high blood pressure and protein in the urine, which can lead to organ damage, seizures, and death. The exact cause of preeclampsia is unknown, but it may be related to abnormal placental development, immune system dysfunction, and genetic factors⁶. Fetal macrosomia is a condition in which the baby is larger than normal, usually weighing more than 4,000 grams at birth. This can cause difficulties during labor and delivery, such as shoulder dystocia, birth trauma, and cesarean section. The main cause of fetal macrosomia is excessive maternal glucose, which stimulates fetal insulin production and growth.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: A sleepy, sedated affect is not a concerning sign, as it is a common side effect of magnesium sulfate. Magnesium sulfate is a central nervous system depressant that can cause drowsiness, lethargy, and reduced alertness.
Choice B reason: Absent ankle clonus is not a concerning sign, as it indicates a normal neuromuscular response. Ankle clonus is a rhythmic jerking of the foot when the ankle is dorsiflexed. It is a sign of hyperreflexia, which can occur in severe preeclampsia due to increased blood pressure and cerebral edema.
Choice C reason: A respiratory rate of 10 breaths/min is a concerning sign, as it indicates respiratory depression. This is a serious complication of magnesium sulfate toxicity, which can lead to respiratory arrest and death. The nurse should monitor the woman's respiratory rate closely and report any signs of respiratory distress.
Choice D reason: Deep tendon reflexes of 2+ are not a concerning sign, as they indicate a normal neuromuscular response. Deep tendon reflexes are graded from 0 to 4, with 2 being the average. Magnesium sulfate can cause hyporeflexia or areflexia, which are signs of magnesium sulfate toxicity.
Correct Answer is D
Explanation
Choice A reason: A blood pressure increase to 138/86 mm Hg is not a concerning finding for preeclampsia. The diagnostic criteria for preeclampsia include a BP of 140/90 mm Hg or higher on two occasions at least 4 hours apart, or a BP of 160/110 mm Hg or higher on one occasion.
Choice B reason: Pitting pedal edema at the end of the day is not a concerning finding for preeclampsia. Edema is a common symptom of pregnancy and can be influenced by factors such as hydration, activity, and posture. Edema is not a reliable indicator of preeclampsia.
Choice C reason: Weight gain of 0.5 kg during the past 2 weeks is not a concerning finding for preeclampsia. The recommended weight gain for a normal-weight woman during pregnancy is 11.5 to 16 kg, with an average of 0.4 kg per week in the second and third trimesters.
Choice D reason: A dipstick value of 3+ for protein in her urine is a concerning finding for preeclampsia. Proteinuria is one of the hallmark signs of preeclampsia and indicates renal impairment. A dipstick value of 3+ corresponds to a protein concentration of 300 mg/dL or higher, which is considered severe.
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