What factor is known to increase the risk of gestational DM?
- A. Weigh 100kg prior to pregnancy
- B. Previous birth AGA
- C. Maternal age younger than 25
- D. Previous diagnosis of type 2 diabetes
Correct Answer: D
Rationale: A previous diagnosis of type 2 diabetes is a known risk factor for developing gestational diabetes mellitus (GDM). Women who have had diabetes prior to pregnancy are more likely to develop GDM due to pre-existing insulin resistance. This increased risk is why healthcare providers closely monitor pregnant women with a history of type 2 diabetes. It is important for these women to manage their blood sugar levels carefully during pregnancy to reduce the risk of complications for both the mother and the baby.
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The nurse is assessing a client at 36 weeks' gestation who reports swelling in the hands and face. What is the priority nursing action?
- A. Check the client’s blood pressure.
- B. Reassure the client that swelling is normal.
- C. Encourage the client to reduce salt intake.
- D. Evaluate the fetal heart rate.
Correct Answer: A
Rationale: Swelling in the hands and face may indicate preeclampsia, requiring immediate blood pressure assessment.
A nurse is caring for a client 2 hr after a spontaneous vaginal birth and the client has saturated two perineal pads with blood in a 30-min period. Which of the following is the priority nursing intervention at this time?
- A. Palpate the client's uterine fundus.
- B. Assist the client on a bedpan to urinate.
- C. Prepare to administer oxytocic medication.
- D. Increase the client's fluid intake.
Correct Answer: A
Rationale: The priority nursing intervention in this situation is to palpate the client's uterine fundus. Saturating two perineal pads with blood in a 30-minute period after childbirth is indicative of excessive postpartum bleeding, also known as postpartum hemorrhage (PPH). Palpating the uterine fundus helps the nurse assess for uterine atony, a common cause of PPH. If the fundus is boggy or not firm, it indicates that the uterus is not contracting effectively to control bleeding, which can lead to further complications if not addressed promptly. Once uterine atony is identified, other interventions such as administering oxytocic medications can be initiated to help the uterus contract and control bleeding.
The nurse is assessing a client with suspected preeclampsia. What symptom supports this diagnosis?
- A. Hyperglycemia.
- B. Proteinuria.
- C. Increased fetal movement.
- D. Hypotension.
Correct Answer: B
Rationale: Proteinuria is a hallmark symptom of preeclampsia, along with hypertension and other systemic findings.
How should a nurse handle a newborn with meconium-stained amniotic fluid?
- A. Suction the airway immediately after birth
- B. Monitor for signs of aspiration
- C. Encourage immediate skin-to-skin contact
- D. Administer antibiotics to the newborn immediately
Correct Answer: A
Rationale: Suctioning the airway immediately reduces the risk of aspiration and respiratory complications.
The nurse is assessing a pregnant client who reports dizziness and lightheadedness when lying on her back. What is the priority intervention?
- A. Administer oxygen via face mask.
- B. Place the client in a left lateral position.
- C. Encourage deep breathing exercises.
- D. Increase IV fluid rate.
Correct Answer: B
Rationale: Supine hypotension syndrome is relieved by positioning the client on her left side to improve blood flow.