HESI case study (solved) Gestational Diabetes (Danielle Greene)_ April 2022 Complete Guide A+ 4 pages

HESI Case Studies - Gestational Diabetes (Danielle Greene)

The clinic nurse reviews Danielle's prenatal record prior to performing a nursing

assessment. Danielle has given birth three times; once at 35 weeks (twins), once at 38

weeks (singleton) and once at 41 weeks (singleton). All of these children are alive and

well. She had one spontaneous abortion at 10 weeks' gestation.

How should the nurse record Danielle's obstetrical history using the G-T-P-A-L

designation? - 5-2-1-1-4

Gravida (no. pregnancies, including current)

Term (after wk 37) {live and stillborn}

Preterm (between 20-37 wk) {live and stillborn}

Abortion (fetal loss, up to 20 weeks)

Living (all alive at time of interview)

Which information does the nurse recognize in the client's history to support a diagnosis

of gestational diabetes? - Child weighed 9 lbs (4.08 kg) at 41 weeks' gestation

Risk Factors:

- previous birth over 9 lbs

- maternal age > 25

- obesity

- hx. of unexplained stillborn

- fam hx of Type 1 diabetes in a first-degree relative

- strong fam hx of type 2 DM

- hx of gest diabetes.

Which instruction should the nurse give the client? - Follow an unrestricted diet and

exercise pattern for at least 3 days before the test.

this allows the test to be a true determination of the body's ability to handled the glucose

load given after the fasting BG is drawn.

The nurse's response should be based on the understanding of which normal

physiologic change of pregnancy? - Hormonal changes in the second and third

trimesters result in increased maternal insulin resistance.

increased levels of H increase insulin resistance bc they act as insulin antagonists -->

glucose-sparing mechanism to ensure an adequate glucose supply to the fetus. Most

pregnant women can handle this insulin resistance, but gest diabetes cannot and

demonstrate an impaired tolerance to glucose during pregnancy --> hyperglycemia

Which response should the nurse give to the client?

Select all that apply - "Hyperglycemia often presents as increased thirst and urination."

"Hyperglycemia causes a headache and flushed, dry skin."

Which responses should the nurse give to the client? - Choose complex carbohydrates

that are high in fiber content.

Avoid foods high in refined sugars.

Drink between 8 to 10 cups of fluids daily.