Maternal Health
Sample Question

Gestational diabetes mellitus (GDM) develops when the physiological changes of pregnancy (eg, rising serum glucose levels, insulin resistance) impair serum glucose regulation. Screening is typically performed around 24-28 weeks gestation and involves a glucose tolerance test.

The nurse should teach the client with GDM to:

• Recognize signs and symptoms of hypoglycemia and check capillary blood glucose levels at prescribed intervals because well-controlled serum glucose levels reduce the risk for complications (Option 1).
• Perform daily exercise to help regulate serum glucose levels and prevent excessive weight gain (Option 2).
• Track fetal movement (eg, kick counts) to monitor fetal well-being because GDM is associated with fetal complications (eg, intrauterine fetal demise) (Option 3).
• Consume a consistent amount of carbohydrates in moderation. The nurse should obtain a referral for the client to collaborate with a dietician to develop an appropriate eating plan (Option 4).
• Monitor for urinary tract and vaginal infections because hyperglycemia can cause glucosuria (ie, the presence of glucose in urine) that can enhance bacterial growth.

(Option 5) Constipation is common during pregnancy due to gastrointestinal slowing from the release of progesterone, intestinal compression by the growing uterus, and iron content in prenatal vitamins. There is no indication for a client with GDM to track bowel movements.

Educational objective:
Gestational diabetes mellitus develops when the physiological changes of pregnancy impair serum glucose regulation. Clients should be taught about recognizing signs and symptoms of hypoglycemia, tracking fetal movement, daily exercise, monitoring for urinary tract infections, and consuming a consistent amount of carbohydrates in moderation.