Question

Discussion Title Discussion Question Answer the questions below providing evidence-based interventions A 34-Years -Old Woman at 24 Weeks Gestation A 32-year-old Hispanic-American woman who is in her second pregnancy and has had one live birth and no abortions is seen for prenatal care at 24 weeks gestation. Her weight is 215 lb, and her blood pressure is 130/80 mmHg. Uterine size is appropriate for gestational age. The patient's past obstetric history includes the spontaneous vaginal delivery of a 9 lb, 10 oz. male infant at 40 weeks gestation, 8 years ago. The patient reports that the child is doing well. Her family history reveals that her mother has type 2 diabetes mellitus. A urine dipstick shows 3+ glycosuria and negative ketones. Questions: 1. What tests should be done to evaluate the patient's glucose tolerance? 2. How is the diagnosis of gestational diabetes mellitus (GDM) established? 3. What are the signs and symptoms of GDM? 4. What would be the best treatment and follow-up strategy? 5. What would be appropriate nursing care for a patient with GDM? 6. What are the complications of the GDM and how could they be prevented? 7. What recommendations should be provided to prevent health problems related to GDM (explain at least 4)

it’s suppose to be a disccussion question,so can some help me answer the questions base on the given scenerio. you could use online sources but citetions are required.

Answer 1

#1. Two test should be done to evaluate the patient's glucose tolerance

• A glucose screening test
• An oral glucose tolerance test (OGTT).

A glucose screening test/ 50-g Oral Glucose Challenge is a routine test during pregnancy to check a pregnant mother's blood glucose level. It is a preliminary test that is performed between 24-28 weeks of pregnancy. During the test, the patient is asked to drink a sweet liquid containing 50 gram of glucose and then the blood will be drawn after an hour of drink. No prior preparation and fasting is required.

An oral glucose tolerance test (OGTT) is finished if a aldohexose or glucose screening check result's beyond traditional. It is mainly done to confirm gestational diabetes. Prior preparation is required. The patient is not allowed to eat or drink anything (sips of water can have) for 8 to 14 hours. The blood is drawn to measure the baseline fasting blood glucose level and then is asked to drink a liquid contains 100 gram of glucose. The blood is drawn and tested every hour for  the next three hours of drink.

#2. Gestational diabetes mellitus (GDM) is defines as any degree of glucose intolerance with onset or first recognition during pregnancy. Women with GDM associated their offspring have an enlarged risk of developing type 2 diabetes mellitus within the future. The global incidence of GDM is tough to estimate, due to lack of uniform diagnostic criteria. Various diagnostic criteria have been proposed. The benefit of treating GDM has also been controversial. The clinical evidence of treating maternal hyperglycemia was made evident in the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study. The HAPO study was a large multinational prospective study (done in women in the third trimester of gestation) demonstrated that there is a continuous association of maternal glucose levels with adverse pregnancy outcomes and this evidence served as the basis for a new set of diagnostic criteria, proposed in 2010 by the International Association of Diabetes and Pregnancy Groups. According to these criteria, the diagnosis of GDM is made if there is at least one abnormal value for fasting, one-hour and two-hour palsma glucose concentration after a 75 gram oral glucose tolerance test.

#3. Th signs and symptoms of Gestational diabetes mellitus (GDM) includes

• Increased sugar in the blood and urine when tested
• Unusual thirst
• Frequent urination or polyuria
• Fatigue
• Nausea
• Frequent vaginal, bladder and skin infections
• Blurred vision

#4. Best treatment and follow-up strategy

Approximately 90% of diabetes cases in pregnant women are considered as gestational diabetes mellitus (GDM). It is a known fact that poor diabetes control during pregnancy affects the health of both the mother and fetus. The treatment plan for gestational diabetes mainly focuses on controlling blood glucose levels through diet, exercise and medication. In addition to this, recommendations for postpartum screening of patients as well as recommendations for use of agents to manage subsequent type 2 diabetes should be detaily explained in patients as a follow-up protocol who are breastfeeding. The reason behind this, it is evident that poor gestational control in future will lead to diabetes mellitus in women which can have an ill-effect on their health.