A pregnant woman who has diabetes mellitus is in the high-risk OB clinic for a checkup. The nurse notes that her hemoglobin A1C (HbAIC) is 5%. Which action by the nurse is most appropriate?
A.
Arrange a referral to the diabetic nurse educator.
B.
Assess for factors leading to noncompliance.
C.
Document the findings in the patient's chart.
D.
Schedule another HbAIC in 4 weeks.
ANS: C
Control of maternal glucose levels (< 7.0% in overtly diabetic women) is an important factor in determining fetal outcome. The glycosylated hemoglobin A1c (HbA1c) level is commonly assessed to guide adjustments in the treatment plan throughout pregnancy. Because the maternal serum HbA1c reflects the degree of glycemic control during the preceding 5 to 6 weeks, the test is repeated every trimester. Good diabetic control is reflected by an HbA1c value of 2.5% to 5.9%; an HbA1c value greater than 8% is indicative of poor diabetic control. Because the patient's value indicates good control, the most appropriate action is documentation. The patient may need to see the diabetic nurse educator, depending on other nursing assessments or patient desire.
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