Page 677 - Saunders Comprehensive Review For NCLEX-RN

determinations 4 times daily (fasting and 1 to 2 hours
after meals) to maintain blood glucose levels as
follows: fasting less than 95 mg/dL (5.4 mmol/L), 1-
hour post-prandial less than 130 to 140 mg/dL (7.4 to
8 mmol/L), 2-hour post-prandial less than 120 mg/dL
(6.8 mmol/L).
2. Encourage moderate physical activity.
3. Facilitate referral to a diabetic educator and
nutritionist.
4. Observe for signs of hyperglycemia, glycosuria and
ketonuria, and hypoglycemia.
5. Monitor weight.
6. Maintain calorie intake as prescribed, with adequate
oral medication or insulin therapy so that glucose
moves into the cells.
7. Assess for signs of maternal complications such as
preeclampsia, a serious blood pressure disorder that
can affect all organs in the body (hypertension is
characteristic of the condition).
8. Monitor for signs of infection.
9. Instruct the client to report burning and pain on
urination, vaginal discharge or itching, or any other
signs of infection to the primary health care provider
(PHCP).
10. Assess fetal status and monitor for signs of fetal
compromise.
11. Schedule visits every 2 weeks until 36 weeks, and then
every week from 36 weeks and up.

F. Interventions during labor

1. Monitor fetal status continuously for signs of distress
and, if noted, prepare the client for immediate
cesarean section.
2. Carefully regulate insulin and provide glucose
intravenously as prescribed because labor depletes
glycogen.

G. Interventions during the postpartum period

1. Observe the mother closely for a hypoglycemic
reaction because a precipitous decline in insulin
requirements normally occurs (the mother may not
require insulin for the first 24 hours).
2. Reregulate insulin needs as prescribed after the first
day, according to blood glucose testing.
3. Assess dietary needs, based on blood glucose testing
and insulin requirements.
4. Monitor for signs of infection or postpartum

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