The nurse is caring for a pregnant patient who is 26 weeks gestation and has a history of gestational diabetes. Which of the following actions is most important for the nurse to monitor during this pregnancy?

Correct Answer: A

Rationale: The correct answer is A: Blood glucose levels and fetal growth. Monitoring blood glucose levels is crucial in managing gestational diabetes to prevent complications for both the mother and baby. High blood glucose levels can lead to macrosomia (excessive fetal growth). Monitoring fetal growth is important to ensure the baby is growing appropriately. Choice B is incorrect because urine protein levels and blood pressure are typically monitored for preeclampsia, not specifically for a patient with gestational diabetes. Choice C is incorrect because while maternal weight gain and diet are important factors, monitoring blood glucose levels takes precedence in managing gestational diabetes. Choice D is incorrect because while fetal heart rate and activity patterns are important, monitoring blood glucose levels is more crucial in this scenario due to the patient's history of gestational diabetes.

Correct Answer: B

Rationale: The correct answer is B: Encourage the patient to perform gentle stretching exercises and maintain good posture. This option promotes active management of lower back pain in pregnancy by improving muscle strength and flexibility, reducing strain on the back. Stretching exercises can help alleviate discomfort and improve posture, which are important for managing back pain during pregnancy. Option A is incorrect as lying flat on the back is contraindicated in pregnancy due to the risk of supine hypotensive syndrome. Option C is incorrect as complete bed rest is not recommended for back pain management. Option D is incorrect as over-the-counter pain medication should be used judiciously during pregnancy and is not the first-line intervention for managing back pain.

Correct Answer: A

Rationale: The correct answer is A: Assess the patient's hemoglobin levels to check for anemia. 1. During pregnancy, anemia is common due to increased blood volume and demands. Fatigue and weakness are common symptoms. 2. Anemia can lead to complications for both the mother and baby if left untreated. 3. Assessing hemoglobin levels will help determine if anemia is present and guide appropriate interventions. 4. Prompt treatment of anemia can improve symptoms and prevent adverse outcomes. Summary: B: Increasing physical activity may exacerbate fatigue if anemia is present. C: Resting is important, but addressing the underlying cause of fatigue is crucial. D: A high-calorie diet may not address the root cause of fatigue and could potentially worsen anemia if not properly managed.

Correct Answer: C

Rationale: The correct answer is C: Decreased blood pressure due to pregnancy-related changes. During pregnancy, blood vessels dilate and the growing uterus can compress the vena cava, leading to decreased blood return to the heart when standing up, causing dizziness and faintness. This condition is known as orthostatic hypotension, common in the third trimester. Low blood sugar levels (choice A) and dehydration/electrolyte imbalance (choice B) can also cause dizziness but are less likely in this scenario. Anemia and low iron levels (choice D) can lead to fatigue and weakness but are less likely to cause dizziness and faintness when standing up in this context.

Correct Answer: B

Rationale: The correct answer is B. Using a firm mattress and avoiding sleeping on the back is the most appropriate recommendation for a pregnant patient at 30 weeks gestation experiencing lower back pain. Here's why: 1. Firm mattress provides better support for the back and helps maintain proper spinal alignment during sleep. 2. Avoiding sleeping on the back reduces pressure on the major blood vessels, preventing potential complications like supine hypotensive syndrome. 3. Resting in bed with legs elevated (choice A) may not address the root cause of back pain and may not be recommended for extended periods during pregnancy. 4. Taking over-the-counter pain medications (choice C) should be avoided unless prescribed by a healthcare provider due to potential risks to the fetus. 5. Performing light stretching exercises (choice D) can be beneficial, but avoiding certain positions like lying on the back is more crucial for back pain relief during pregnancy.