Question

Scenario: you are working as a registered nurse in a large women’s clinic. YL, a 28-year-old Asian woman arrives for her regularly scheduled appointment. She is in her 26^th week of pregnancy and is a primigravida. After examining the patient, the nurse midwife tells you to schedule YL for a glucose challenge test. You review YL’s chart and note she is 5 feet, 3 inches tall and weighs 143 lbs; her pre-pregnancy body mass index was 25. Her father has type 2 diabetes mellitus, and both paternal grandparents had type 2 DM. You enter the room to talk to YL.

Laboratory test results:

Time of test	Value	Normal Range
0730	109 mg/dL	Less than or equal to 92 mg/dL
0830	213 mg/dL	Less than or equal to 180 mg/dL
0930	162 mg/dL	Less than or equal to 153 mg/dL

6. YL asks whether having gestational diabetes will hurt her baby. How will you respond?
7. At the conclusion of the visit, you need to evaluate your teaching. Which statement made by YL indicates that clarification is necessary? A.“I will stay on the diabetic diet described by the dietitian." B.“I will monitor my glucose levels at least four times each day." C. “I need to stop exercising because I will need more carbohydrates." D. “I should immediately report any ketones in my urine.”

8. YL states that she plans to have another child soon and asks you if she will develop gestational diabetes with that pregnancy. Select the best response.

A.“Yes, once you develop gestational diabetes, you will develop it with all future pregnancies.”

B. “No, there is no further risk for development of gestational diabetes if you get pregnant again.”

C. “If you lose weight and do not eat any sweets before your next pregnancy, you will not develop gestational diabetes again.”

D. “There is a risk for recurrence of gestational diabetes in the next pregnancy. Let your health care provider know that you had gestational diabetes with this pregnancy.”

Answer 1

Having gestational DIABETES can hurt your baby by some of these features ---- incresed weight of the baby , preterm baby , hypoglycemic baby sometimes , stillbirth , baby may have DIABETES in later life , breathing difficulties , difficulties in labour causing injury to the baby .

The statement D needs clarification because her doctor advised to check for ketones in her urine which indicates increased diabetic may cause diabtic ketoacidosis which caused ketones to appear in urine giving frothy appearance indicating it is a medical emergency to decrese patients blood glucose level..

The correct option for YL planning to have next baby is

D. There is a risk for recurrence of gestational DIABETIS in the next pregnancy , let your healthcare provider know that you had gestational DIABETES with this pregnancy .