A diabetic patient goes into labor at 36 weeks' gestation. Provided that tests for fetal lung maturity are successful, the nurse will anticipate: Note: Credit will be given only if all correct and no incorrect choices are selected
Select all that apply. 1. Administration of tocolytic therapy.
2. Beta-sympathomimetic administration.
3. Allowance of labor to progress.
4. Hourly blood glucose monitoring.
5. Cesarean birth if the HgbA1c is 7%.
3,4
Rationale 1: Tocolytic therapy will not be used, as it can increase the maternal blood glucose.
Rationale 2: B-sympathomimetics will not be administered, as they can increase the maternal blood glucose.
Rationale 3: There will be no attempt to stop the labor, as this can compromise the mother and fetus.
Rationale 4: A euglycemic state is desirable to avoid fetal hypoglycemia.
Rationale 5: A cesarean birth would be considered if the HgbA1c were increasing, as this would indicate sustained hyperglycemia.
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