The Pregnant Client with Diabetes

A client with gestational diabetes who is entering her third trimester is learning how to moni- tor her fetus's movements. After teaching the cli- ent about the kick count, the nurse should provide further instruction if the client makes which of the following statements?

"The baby should be moving less than 10 times in 3 hours."

When developing a teaching plan for a primigravid client with insulin-dependent diabetes about monitoring blood glucose control and insulin dosages at home, which of the following would the nurse expect to include as a desired target range for blood glucose levels?

60 to 100 mg/dL before meals and bedtime snacks.

A primigravid client with insulin-dependent diabetes tells the nurse that the contraction stress test performed earlier in the day was suspicious. The nurse interprets this test result as indicating that the fetal heart rate pattern showed which of the following?

Inconsistent late decelerations.

Which of the following statements about a fetal biophysical profile would be incorporated into the teaching plan for a primigravid client with insulin-dependent diabetes?

It is noninvasive using real-time ultrasound.

At 38 weeks' gestation, a primigravid client with poorly controlled diabetes and severe preec- lampsia is admitted for a cesarean delivery. The nurse explains to the client that delivery helps to prevent which of the following?

Stillbirth.

A 27-year-old primigravid client with insulin-dependent diabetes at 34 weeks' gestation undergoes a nonstress test, the results of which are documented as reactive. The nurse should tell the client that the test results indicate which of the fol- lowing?

There is evidence of fetal well-being.

With plans to breast-feed her neonate, a pregnant client with insulin-dependent diabetes asks the nurse about insulin needs during the post- partum period. Which of the following statements about postpartal insulin requirements for breast- feeding mothers should the nurse include in the explanation?

They fall significantly in the immediate post-partum period.

A 30-year-old multigravid client at 8 weeks' gestation has a history of insulin-dependent diabetes since age 20. When explaining about the importance of blood glucose control during pregnancy, the nurse should tell the client that which of the following will occur regarding the client's insulin needs dur- ing the first trimester?

They will decrease.

The nurse explains the complications of pregnancy that occur with diabetes to a primigravid client at 10 weeks' gestation who has a 5-year his- tory of insulin-dependent diabetes. Which of the following, if stated by the client as a complication, indicates the need for additional teaching?

Twin-to-twin transfer.

After teaching a diabetic primigravida about symptoms of hyperglycemia and hypoglycemia, the nurse determines that the client understands the instruction when she says that hyperglycemia may be manifested by which of the following?

Dehydration.

A primigravid client with diabetes at 39 weeks' gestation is seen in the high-risk clinic. The physician estimates that the fetus weighs at least 4,500 g (10 lb). The client asks, "What causes the baby to be so large?" The nurse's response is based on the understanding that fetal macrosomia is usually related to which of the following?

Maternal hyperglycemia.

When teaching a primigravid client with diabetes about common causes of hyperglycemia during pregnancy, which of the following would the nurse include?

Maternal infection.