Gestational Diabetes Questions and Answers Already Passed

Gestational Diabetes Questions and Answers Already Passed The nurse reviews the client's prenatal record prior to performing a nursing assessment. The client has given birth three times; once at 35 weeks (twins), once at 38 weeks (singleton) and once at 41 weeks (singleton). All of these children are alive and well. She had one spontaneous abortion at 10 weeks gestation. How should the nurse record the client's obstetrical history using the G-T-P-A-L designation? 5-2-1-1-4 Gravidity is defined as the number of times pregnant, INCLUDING CURRENT PREGNANCY. Term is defined as any birth after the end of the 37th week, and preterm refers to any births between 20 and 37 weeks. Both term and preterm describe liveborn AND STILLBORN infants. Abortion is any fetal loss, whether spontaneous or elective, up to 20 weeks gestation. Living refers to all children who are living at the time of the interview. Multiple fetuses such as twins, triplets, and beyond are treated as ONE pregnancy and ONE birth when recording the GTPAL. This client's GTPAL is 5 (pregnancies counting current one) - 2 (infants born at 38 and 41 weeks) - 1 (twins born at 35 weeks) - 1 (spontaneous abortion at 10 weeks) - 4 (each twin and the 2 singletons, all living). The nurse notes that the client's fasting one-hour glucose screening levelfrom last week is 164 mg/dL. Which information does the nurse recognize in the client's history to support a diagnosis of gestational diabetes? Child weighed 9 lbs. (4.08 kg) at 41 weeks' gestation. Birth of an infant weighing more than 9 lbs (4.08 kg) is a risk factor for gestational diabetes. Other risk factors include maternal age older than 25, obesity, history of unexplained stillborn, family history of Type 1 diabetes in a first-degree relative, strong family history of Type 2 diabetes, and history of gestational diabetes in a previous pregnancy. Ethnic groups at increased risk include Hispanic, Native-American, Asian, and African-American. The client is scheduled for a 3-hour oral glucose tolerance test in 5 days and is told to arrive at the lab at 8:30 am. The client asks if there are any special instructions for the test in addition to fasting for 8 hours immediately prior to the test. Which instruction should the nurse give the client? Follow an unrestricted diet and exercise pattern for at least 3 days before the test. When the client follows an unrestricted diet (including at least 150 g of carbohydrates) and regular exercise patterns, the test is a true determination of the body's ability to handle the glucose load given after the fasting blood glucose is drawn. The client asks the nurse why she wasn't tested for gestational diabetes until she was at almost 28 weeks gestation. The nurse's response should be based on the understanding of which normal physiologic change of pregnancy? Hormonal changes in the second and third trimesters result in increased maternal insulin resistance. Increased levels of hormones increase insulin resistance because they act as insulin antagonists. This serves as a glucose-sparing mechanism to ensure an adequate glucose supply to the fetus. While most pregnant women's bodies are able to handle this insulin resistance, women with gestational diabetes cannot and therefore demonstrate an impaired tolerance to glucose during pregnancy and develop hyperglycemia. The client's 3-hour oral glucose tolerance test indicates that she does have gestational diabetes. The nurse phones her and arranges for her to meet with the obstetrician, as well as an diabetes educator and a registered dietician (RD) the next day. The obstetrician and the nurse discuss gestational diabetes with the client. After seeking her input, they outline their suggested plan of care, which includes dietary control and glucose