NM 706 Exam 3 STUDY FINAL EDITION
fully solved already passed
ACOG GDM early screening criteria - correct answer ✔✔- BMI > 25 --> Asian Americans = BMI > 23
AND ≥ one of the following:
- physical inactivity
- 1st degree relative with DM
- high risk race or ethnicity --> black, Latino, native American, Asian American, pacific islander
- Hx of infant ≥ 4000 g (≈ 9#)
- Hx GDM
- HTN --> 140/90 or taking HTN meds
- HDL < 35, triglycerides > 250
- PCOS
- HbA1C ≥ 5.7%, impaired glucose tolerance, or impaired fasting glucose on previous testing = 1 high
level on 3 hr GTT
- other conditions associated with insulin resistance --> prepreg BMI > 40, acanthosis nigricans
- Hx CVD
ACOG 24-28 wks GDM screen - correct answer ✔✔1 hr 50 g GTT
ACOG 24-28 wks results of ______ is automatic GDM - correct answer ✔✔≥ 200
ACOG 24-28 wks at risk for GDM results - correct answer ✔✔≥ 130-140 = do a 3 hr 100 g GTT test
NDDG 3 hr 100 g GTT test results - correct answer ✔✔- 2 increased values = GDM
- 1 increased value = consider retest or just Tx
- FBS > 105
- 1 hr > 190
,- 2 hr > 165
- 3 hr > 145
C&C 3 hr 100 g GTT test results - correct answer ✔✔- 2 increased values = GDM
- 1 increased value = consider retest or just Tx
- FBS > 95
- 1 hr > 180
- 2 hr > 155
- 3 hr > 140
early screening HbA1C - correct answer ✔✔- ≤ 6.1% = repeat @ 24-28 wks
- > 6.1% = PGDM = DM prior to preg = consult with possible transfer of care
GDM selective screening --> do NOT screen if - correct answer ✔✔- < 25 yrs
- NOT hispanic, black, native american, south or east asian, pacific islander
- BMI ≤ 25
- no Hx of abnormal glucose tolerance
- no Hx of adverse OB outcomes --> stillbirth, macorsomia
- no 1st degree relative with DM
maternal glucose checks - correct answer ✔✔- 4/day --> 1 x after fasting & after each meal 1-2 hrs after
eating
- once glucose well controlled by diet --> unusually recommend 2 measurements/day
maternal glucose levels should be - correct answer ✔✔- fasting < 95
- postprandial < 140 @ 1 hr or < 120 @ 2 hrs --> to reduce risk of macrosomia
antenatal GDM monitoring - correct answer ✔✔- diet & exercise control testing not necessary
- insulin or PO meds --> antenatal surveillance starting @ 32 wks & daily kick counts r/t ↑ risk of stillbirth
, - fundal hghts
- leopolds
- mom's wght
- fluid retention
- VS --> especially b/p
- review blood sugars & diet diary
low recommended plasma glucose thresholds in healthy term infants - correct answer ✔✔- 1-2 hrs after
birth = 28
- 3-23 hrs after birth = 40
- 24-47 hrs after birth = 41
- 48-72 hrs after birth = 48
screening for late preterm & term SGA, IDM/LGA infant Sx infants & sugar < 40 then give - correct answer
✔✔- IV glucose --> D10 H2O
screening for late preterm & term SGA, IDM/LGA infant aSx infant birth - 4 hrs of age with initial feed
within 1 hr then screen glucose - correct answer ✔✔- 30 minutes after 1st feed
aSx infant birth - 4 hrs of age with initial feed within 1 hr & initial glucose < 25 then - correct answer ✔✔-
feed again & recheck in 1 hr
screening for late preterm & term SGA, IDM/LGA infant aSx infant birth - 4 hrs of age with initial feed
within 1 hr & initial glucose < 25 then & fed again & rechecked in 1 hr & - correct answer ✔✔- still < 25 =
give IV glucose
- 25-40 = refeed/IV glucose/PO glucose PRN
screening for late preterm & term SGA, IDM/LGA infant aSx infant 4-24 hrs of age - correct answer ✔✔-
continued feeds every 2-3 hrs
- check sugar prior to each feed
fully solved already passed
ACOG GDM early screening criteria - correct answer ✔✔- BMI > 25 --> Asian Americans = BMI > 23
AND ≥ one of the following:
- physical inactivity
- 1st degree relative with DM
- high risk race or ethnicity --> black, Latino, native American, Asian American, pacific islander
- Hx of infant ≥ 4000 g (≈ 9#)
- Hx GDM
- HTN --> 140/90 or taking HTN meds
- HDL < 35, triglycerides > 250
- PCOS
- HbA1C ≥ 5.7%, impaired glucose tolerance, or impaired fasting glucose on previous testing = 1 high
level on 3 hr GTT
- other conditions associated with insulin resistance --> prepreg BMI > 40, acanthosis nigricans
- Hx CVD
ACOG 24-28 wks GDM screen - correct answer ✔✔1 hr 50 g GTT
ACOG 24-28 wks results of ______ is automatic GDM - correct answer ✔✔≥ 200
ACOG 24-28 wks at risk for GDM results - correct answer ✔✔≥ 130-140 = do a 3 hr 100 g GTT test
NDDG 3 hr 100 g GTT test results - correct answer ✔✔- 2 increased values = GDM
- 1 increased value = consider retest or just Tx
- FBS > 105
- 1 hr > 190
,- 2 hr > 165
- 3 hr > 145
C&C 3 hr 100 g GTT test results - correct answer ✔✔- 2 increased values = GDM
- 1 increased value = consider retest or just Tx
- FBS > 95
- 1 hr > 180
- 2 hr > 155
- 3 hr > 140
early screening HbA1C - correct answer ✔✔- ≤ 6.1% = repeat @ 24-28 wks
- > 6.1% = PGDM = DM prior to preg = consult with possible transfer of care
GDM selective screening --> do NOT screen if - correct answer ✔✔- < 25 yrs
- NOT hispanic, black, native american, south or east asian, pacific islander
- BMI ≤ 25
- no Hx of abnormal glucose tolerance
- no Hx of adverse OB outcomes --> stillbirth, macorsomia
- no 1st degree relative with DM
maternal glucose checks - correct answer ✔✔- 4/day --> 1 x after fasting & after each meal 1-2 hrs after
eating
- once glucose well controlled by diet --> unusually recommend 2 measurements/day
maternal glucose levels should be - correct answer ✔✔- fasting < 95
- postprandial < 140 @ 1 hr or < 120 @ 2 hrs --> to reduce risk of macrosomia
antenatal GDM monitoring - correct answer ✔✔- diet & exercise control testing not necessary
- insulin or PO meds --> antenatal surveillance starting @ 32 wks & daily kick counts r/t ↑ risk of stillbirth
, - fundal hghts
- leopolds
- mom's wght
- fluid retention
- VS --> especially b/p
- review blood sugars & diet diary
low recommended plasma glucose thresholds in healthy term infants - correct answer ✔✔- 1-2 hrs after
birth = 28
- 3-23 hrs after birth = 40
- 24-47 hrs after birth = 41
- 48-72 hrs after birth = 48
screening for late preterm & term SGA, IDM/LGA infant Sx infants & sugar < 40 then give - correct answer
✔✔- IV glucose --> D10 H2O
screening for late preterm & term SGA, IDM/LGA infant aSx infant birth - 4 hrs of age with initial feed
within 1 hr then screen glucose - correct answer ✔✔- 30 minutes after 1st feed
aSx infant birth - 4 hrs of age with initial feed within 1 hr & initial glucose < 25 then - correct answer ✔✔-
feed again & recheck in 1 hr
screening for late preterm & term SGA, IDM/LGA infant aSx infant birth - 4 hrs of age with initial feed
within 1 hr & initial glucose < 25 then & fed again & rechecked in 1 hr & - correct answer ✔✔- still < 25 =
give IV glucose
- 25-40 = refeed/IV glucose/PO glucose PRN
screening for late preterm & term SGA, IDM/LGA infant aSx infant 4-24 hrs of age - correct answer ✔✔-
continued feeds every 2-3 hrs
- check sugar prior to each feed
