Exam 29: Endocrine and Metabolic Disorders

Which statement regarding the laboratory test for glycosylated hemoglobin A_lc is correct?

Hypothyroidism occurs in 2 to 3 pregnancies per 1000.Because severe hypothyroidism is associated with infertility and miscarriage,it is not often seen in pregnancy.Regardless of this fact,the nurse should be aware of the characteristic symptoms of hypothyroidism.Which do they include? (Select all that apply. )

A woman diagnosed with gestational diabetes has had little or no experience reading and interpreting glucose levels.The client shows the nurse her readings for the past few days.Which reading signals the nurse that the client may require an adjustment of insulin or carbohydrates?

A new mother with a thyroid disorder has come for a lactation follow-up appointment.Which thyroid disorder is a contraindication for breastfeeding?

Which preexisting factor is known to increase the risk of gestational diabetes mellitus (GDM)?

During a prenatal visit,the nurse is explaining dietary management to a woman diagnosed with pre-gestational diabetes.Which statement by the client reassures the nurse that teaching has been effective?

Preconception counseling is critical in the safe management of diabetic pregnancies.Which complication is commonly associated with poor glycemic control before and during early pregnancy?

Which physiologic alteration of pregnancy most significantly affects glucose metabolism?

The nurse is preparing to teach an antepartum client with GDM the correct method of administering an intermediate-acting insulin,such as neutral protamine Hagedorn (NPH),with a short-acting insulin (regular).In the correct order from 1 through 6,match the step number with the action needed to teach the client self-administration of this combination of insulin. -Step 1

An 18-year-old client who has reached 16 weeks of gestation was recently diagnosed with pre-gestational diabetes.She attends her centering appointment accompanied by one of her girlfriends.This young woman appears more concerned about how her pregnancy will affect her social life than her recent diagnosis of diabetes.Several nursing diagnoses are applicable to assist in planning adequate care.What is the most appropriate diagnosis at this time?

The nurse is preparing to teach an antepartum client with GDM the correct method of administering an intermediate-acting insulin,such as neutral protamine Hagedorn (NPH),with a short-acting insulin (regular).In the correct order from 1 through 6,match the step number with the action needed to teach the client self-administration of this combination of insulin. -Step 3

The nurse is preparing to teach an antepartum client with GDM the correct method of administering an intermediate-acting insulin,such as neutral protamine Hagedorn (NPH),with a short-acting insulin (regular).In the correct order from 1 through 6,match the step number with the action needed to teach the client self-administration of this combination of insulin. -Step 6

Which statement concerning the complication of maternal diabetes is the most accurate?

The nurse is preparing to teach an antepartum client with GDM the correct method of administering an intermediate-acting insulin,such as neutral protamine Hagedorn (NPH),with a short-acting insulin (regular).In the correct order from 1 through 6,match the step number with the action needed to teach the client self-administration of this combination of insulin. -Step 5

The nurse is preparing to teach an antepartum client with GDM the correct method of administering an intermediate-acting insulin,such as neutral protamine Hagedorn (NPH),with a short-acting insulin (regular).In the correct order from 1 through 6,match the step number with the action needed to teach the client self-administration of this combination of insulin. -Step 4

The nurse is preparing to teach an antepartum client with GDM the correct method of administering an intermediate-acting insulin,such as neutral protamine Hagedorn (NPH),with a short-acting insulin (regular).In the correct order from 1 through 6,match the step number with the action needed to teach the client self-administration of this combination of insulin. -Step 2

To manage her diabetes appropriately and to ensure a good fetal outcome,how would the pregnant woman with diabetes alter her diet?

A 26-year-old primigravida has come to the clinic for her regular prenatal visit at 12 weeks.She appears thin and somewhat nervous.She reports that she eats a well-balanced diet,although her weight is 5 pounds less than it was at her last visit.The results of laboratory studies confirm that she has a hyperthyroid condition.Based on the available data,the nurse formulates a plan of care.Which nursing diagnosis is most appropriate for the client currently?

In terms of the incidence and classification of diabetes,which information should the nurse keep in mind when evaluating clients during their ongoing prenatal appointments?

A client with maternal phenylketonuria (PKU)has come to the obstetrical clinic to begin prenatal care.Why would this preexisting condition result in the need for closer monitoring during pregnancy?