The clinic RN reviews Amanda's prenatal record prior to performing a nursing assessment. Amanda has given birth twice, once at 35-weeks (twins) and once at 39-weeks (singleton). All of these children are alive and well. She has had one spontaneous abortion at 9-weeks gestation.
1.
How should the nurse record Amanda's obstetrical history using the G-T-P-A-L designation?
A) 3-2-0-1-3.
B) 3-1-1-1-2.
C) 4-1-1-1-3.
D) 4-2-1-0-2.
Correct answer(s): C
The nurse notes that Amanda's fasting 1 hour glucose screening level, which was done two days previously, is 158 mg/dl.
2.
The nurse recognizes that what information in the client's history supports a diagnosis of gestational diabetes?
A) Maternal great-aunt has insulin dependent (Type 1) diabetes.
B) Youngest child weighed 4300 grams at 39-weeks gestation.
C) Trace of protein noted in urine specimen at last prenatal visit.
D) Client is 64 inches tall and weighed 134 prior to pregnancy.
Correct answer(s): B
Further Glucose Screening
Amanda is scheduled for a 3 hour oral glucose tolerance test in 5 days, and is told to arrive at the lab at 8:30 am. Amanda asks if there are any special instructions for the test in addition to fasting for 8 hours immediately prior to the test.
3.
Which instruction should the nurse give the client?
A) Only coffee or tea is allowed once the fasting level has been drawn.
B) Follow an unrestricted diet and exercise pattern for at least 3 days before the test.
C) Write down questions and call the laboratory for instructions the day before the test.
D) Smoking in moderation is allowed up until the time the test begins.
Correct answer(s): B
Amanda asks the nurse why she wasn't tested for gestational diabetes until she was almost 28-weeks gestation.
4.
The nurse's response should be based on the understanding of which normal physiologic change of pregnancy?
A) Maternal insulin crosses the placenta to regulate fetal glucose levels throughout