The nurse is assessing a client with suspected gestational diabetes. What is the most reliable diagnostic test?

Correct Answer: B

Rationale: The most reliable diagnostic test for suspected gestational diabetes is the Oral Glucose Tolerance Test (OGTT). This test involves the client fasting overnight and then drinking a glucose solution followed by blood draws to measure glucose levels at specific intervals. The OGTT is considered the gold standard for diagnosing gestational diabetes because it provides a more comprehensive assessment of the body's ability to regulate glucose levels over time. It can detect abnormalities in glucose metabolism that may not be captured by a single blood glucose measurement. In contrast, a random blood glucose test (Option A) may not provide an accurate representation of the client's glucose tolerance as it can be influenced by recent food intake. A fasting blood glucose test (Option C) only provides a snapshot of glucose levels at one point in time and may miss postprandial hyperglycemia common in gestational diabetes. Hemoglobin A1C (Option D) is not recommended for diagnosing gestational diabetes as it reflects average blood glucose levels over the past 2-3 months and may not capture recent changes in glucose metabolism during pregnancy. Educationally, understanding the rationale behind diagnostic tests for gestational diabetes is crucial for nurses caring for pregnant clients. By knowing the strengths and limitations of each test, nurses can advocate for appropriate screening and diagnostic procedures to ensure the best outcomes for both the mother and baby.

Correct Answer: A

Rationale: In educating pregnant clients about kick counts, it is crucial to emphasize the significance of fetal movement as an indicator of fetal well-being. The correct answer is A) Fewer than 10 movements in 2 hours because a decrease in fetal movements could signal potential fetal distress and requires prompt evaluation by a healthcare provider. This frequency is a widely accepted guideline for when a mother should contact her healthcare provider. Option B) Fewer than 20 movements in 1 hour sets a higher threshold than the standard recommendation, potentially delaying necessary medical intervention. Option C) No movement in 4 hours poses a risk by allowing too much time to pass without monitoring fetal activity. Option D) No movement after eating a meal is not a standard criterion for assessing fetal well-being and may lead to unnecessary concerns or delays in seeking medical attention when needed. Educationally, it is important for nurses to teach pregnant clients the importance of regular kick counts, when to perform them, and what to do if there are concerning changes in fetal movement. This empowers clients to be proactive in monitoring their baby's health and seeking timely medical assistance when needed.

Correct Answer: C

Rationale: In postpartum education, it is crucial to emphasize the importance of recognizing warning signs that could indicate a potential complication. In this scenario, the correct answer is C) Severe headache and blurred vision, which should be reported immediately. These symptoms could be indicative of conditions such as preeclampsia or eclampsia, which are serious and require prompt medical attention to prevent harm to the mother. Option A) Increased lochia on standing is a common postpartum occurrence, especially if the client has been active. It is important to educate clients on the expected amount and color of lochia, but increased flow upon standing alone is not typically a cause for immediate concern. Option B) Breast tenderness and fullness are common postpartum symptoms related to breastfeeding. While these symptoms should be addressed to ensure proper latch and milk supply, they do not typically indicate a serious complication that requires immediate reporting. Option D) Mild swelling in the feet is a common postpartum symptom due to fluid shifts in the body. While some swelling is expected, sudden severe swelling accompanied by other symptoms like headache and blurred vision could be concerning. However, mild swelling alone is not an immediate cause for alarm. Educational context is crucial in helping postpartum clients differentiate between normal postpartum experiences and potential warning signs. By explaining the rationale behind the correct answer and why the other options are not immediate concerns, nurses can empower clients to advocate for their health and seek timely medical intervention when necessary.

Correct Answer: C

Rationale: In caring for a client with gestational diabetes, monitoring for fetal complications is crucial. The correct answer is C) Hypoglycemia. Infants born to mothers with gestational diabetes are at risk for hypoglycemia due to their exposure to higher glucose levels in utero. After birth, the infant's insulin production remains high, leading to a drop in blood glucose levels, hence the need for vigilant monitoring. Option A) Hyperglycemia is incorrect because infants are not at risk for high blood sugar levels after birth. Option B) Macrosomia, referring to a large birth weight, is a risk factor associated with gestational diabetes but does not directly relate to postnatal complications. Option D) Hyperbilirubinemia, or jaundice, is a common condition in newborns but is not specifically linked to gestational diabetes. Educationally, understanding the impact of maternal gestational diabetes on fetal health is essential for nursing practice. By grasping the increased risk of hypoglycemia in infants of diabetic mothers, nurses can provide timely interventions and support to ensure optimal outcomes for both the mother and the newborn.

Correct Answer: A

Rationale: In the context of prenatal care, teaching expectant mothers about monitoring fetal movements, known as kick counts, is crucial for assessing fetal well-being. The correct answer, option A, states that the client should contact the healthcare provider if there are fewer than 10 movements in 2 hours. This guideline is based on the recommendation that expectant mothers should feel at least 10 distinct movements within a 2-hour period, which indicates normal fetal activity and a healthy baby. Option B, fewer than 5 movements in 1 hour, is incorrect because it sets a threshold that is too low and may lead to unnecessary anxiety and interventions. Fetal movement patterns can vary, and setting the bar too high may cause undue concern. Option C, no movements after a meal, is also incorrect as fetal movements can vary in relation to maternal activities and are not solely tied to meal times. Option D, no movements for 6 hours, is incorrect because waiting for this extended period without feeling fetal movements could potentially delay necessary medical intervention in cases of fetal distress. Educationally, it is important for nurses to teach expectant mothers the significance of kick counts, how to perform them correctly, and when to seek medical advice based on established guidelines. This empowers mothers to actively monitor their baby's well-being and promotes early detection of any potential issues, contributing to optimal maternal and fetal outcomes.