The nurse is educating a client about gestational diabetes. What is the best recommendation for managing blood sugar levels?

Correct Answer: C

Rationale: In the context of managing gestational diabetes, the best recommendation for managing blood sugar levels is option C: Eat balanced meals and monitor blood sugar levels. This recommendation is crucial as it emphasizes a holistic approach to managing blood sugar levels during pregnancy. Eating balanced meals ensures that the client receives a mix of nutrients, including carbohydrates, which are essential for energy. Monitoring blood sugar levels allows the client to track how different foods affect their blood sugar and make necessary adjustments. This approach promotes stable blood sugar levels, which is vital for the health of both the mother and the baby. Option A, avoiding all carbohydrates, is not recommended as carbohydrates are an important source of energy and nutrients. Completely eliminating them can lead to nutritional deficiencies and is not sustainable in the long term. Option B, exercising for 60 minutes daily, is beneficial for overall health but may not be sufficient on its own to manage blood sugar levels in gestational diabetes. While exercise is important, dietary management and blood sugar monitoring play a more direct role in controlling blood sugar levels. Option D, only taking insulin when blood sugar is high, is not a comprehensive approach to managing gestational diabetes. Relying solely on insulin without addressing dietary factors and monitoring blood sugar levels may not provide optimal control and can lead to fluctuations in blood sugar levels. In an educational context, it is important for nurses to emphasize the importance of a balanced approach to managing gestational diabetes, including proper nutrition, regular monitoring, and, if needed, appropriate medication. Empowering clients with the knowledge and skills to manage their condition effectively can lead to better outcomes for both the mother and the baby.

Correct Answer: B

Rationale: In the postpartum period, the finding that indicates a need for immediate intervention is option B) Lochia rubra with large clots. Lochia rubra is the normal vaginal discharge after childbirth, but the presence of large clots can indicate excessive bleeding or retained placental tissue, which are serious postpartum complications requiring immediate medical attention to prevent hemorrhage and infection. Option A) Fundus firm and midline is a normal finding indicating proper uterine involution, which is expected in the postpartum period. Option C) Perineal pain after delivery is common due to the trauma of childbirth and is managed with pain relief measures. Option D) Slight swelling of the feet can be a normal postpartum symptom due to fluid shifts, but it does not require immediate intervention unless it is severe and associated with other signs of preeclampsia. In an educational context, it is crucial for nurses working in maternal newborn care to recognize abnormal postpartum findings that require immediate intervention to ensure the well-being of the mother. Understanding normal postpartum changes and potential complications is essential in providing safe and effective care to postpartum clients. Regular assessment and early detection of abnormal findings can prevent serious postpartum complications and promote optimal recovery for the mother.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Compression of pelvic nerves. Leg cramps during pregnancy, especially at 20 weeks' gestation, can be attributed to the growing uterus exerting pressure on the pelvic nerves, leading to compression and subsequent leg cramps. This is a common occurrence in pregnancy due to the expanding uterus putting pressure on surrounding structures. Option A) Dehydration is less likely to be the cause of leg cramps in this case, as the physiological changes in pregnancy often lead to an increased need for fluid intake. However, dehydration can contribute to muscle cramps in general. Option B) Calcium deficiency is an important consideration during pregnancy, but it is less likely to be the primary cause of leg cramps at 20 weeks' gestation. Adequate calcium intake is crucial for bone health and muscle function, but in this case, nerve compression is the more likely cause. Option C) Increased blood volume is a normal adaptation during pregnancy, but it is not directly linked to the development of leg cramps. While changes in blood volume can impact circulation and potentially contribute to other symptoms, it is not the primary reason for leg cramps in this context. Educationally, understanding the physiological changes and common discomforts experienced during pregnancy is essential for nurses caring for expectant mothers. Recognizing the causes of symptoms like leg cramps helps nurses provide appropriate education, support, and interventions to promote maternal well-being throughout pregnancy.

Correct Answer: B

Rationale: In the case of a client at 34 weeks' gestation diagnosed with polyhydramnios, the nurse's priority assessment should be to assess for signs of preterm labor, making option B the correct answer. Polyhydramnios, an excess of amniotic fluid, can increase the risk of preterm labor due to uterine distention and placental compression. By assessing for signs of preterm labor such as regular uterine contractions, lower back pain, pelvic pressure, or vaginal bleeding, the nurse can intervene promptly to prevent premature birth and its associated complications. Monitoring maternal blood pressure (option A) is important in prenatal care, but in this specific scenario, the risk of preterm labor takes precedence. Checking for signs of infection (option C) is also important but not the priority when dealing with polyhydramnios and its potential complications. Evaluating fetal heart rate changes (option D) is crucial in many situations, but in this case, assessing for preterm labor is more directly related to the client's current condition and needs. This educational context highlights the critical thinking skills required in maternal newborn nursing to prioritize assessments based on the client's specific condition and potential risks. Nurses must be able to recognize the most urgent needs of their clients to provide timely and appropriate care, especially in high-risk situations such as polyhydramnios during pregnancy.

Correct Answer: C

Rationale: In the context of maternal newborn nursing, understanding postpartum depression is crucial for both nurses and clients. Option C, "I should seek help if I feel disconnected from my baby," indicates understanding because postpartum depression can manifest as feelings of disconnection from the baby, among other symptoms. Seeking help is essential for early intervention and effective management. Option A, "It’s normal to feel hopeless for several weeks," is incorrect because while some mood fluctuations are normal postpartum, persistent feelings of hopelessness may indicate a more serious issue like postpartum depression. Option B, "Postpartum depression only occurs in first-time mothers," is incorrect as postpartum depression can affect any mother, regardless of whether it is their first child or not. Option D, "It is caused by a lack of support from family," is incorrect because while lack of support can contribute to postpartum depression, it is not the sole cause as there are multifactorial reasons for its development. Educationally, this question highlights the importance of recognizing the signs and symptoms of postpartum depression, emphasizing the need for early intervention and support for mothers experiencing this condition to promote maternal mental health and bonding with the newborn.