Gestational Diabetes

Gestational Diabetes

Part 1

The complication is Gestational Diabetes (GD). According to Mayo Clinic (2020), the diagnosis of the disease is carried out by Glucose challenge test (GCT) and glucose tolerance testing. During the screening test, the former is initiated, and blood sugar levels under 140mg/dl are considered normal. If the level is higher than the average, glucose tolerance testing follows. This examination has a similar mechanism like for GCT, although the syrup solution is more concentrated and carried out for three hours and readings recorded in an hourly interval. If at least two of the readings go above the average level, gestational diabetes is diagnosed. Elena’s results in both tests were abnormally high.

Part 2

Maternal

High blood pressure

Miscarriage

Sleep apnea

Cardiac dysfunction

Preeclampsia

Type II diabetes

Cesarean delivery, which in turn leads to risks of bleeding and infection.

Fetal

Death of the fetus in miscarriages and stillbirths.

Preterm birth

Fetal macrosomia

Diagnostic testing problems due to obesity. For instance, in the ultrasound exams.

Newborn

Respiratory distress syndrome

Hypoglycemia

Obesity

Type II diabetes

Still

Part 3

Health History

What other problems did you suffer from in your first pregnancy? And how was the issue managed?

What health issues has your child been diagnosed with? What was the management plan?

Did your mother ever have Gestational Diabetes?

Clinical tests

In your last pregnancy, how long did it take for you to gain 65 pounds? And at what period did it rise abruptly?

Did you lose weight after giving birth to your daughter? Through which interventions?

Were ultrasound examinations effective?

Do you feel a difference in the two pregnancies?

How you noticed any unusual symptoms? Like excessive urination and an increase in thirst. When did they start? How long do the symptoms recur?

Psychosocial

Do you smoke? Or does anyone in your household smoke?

Does your family support and motivate you?

Apart from diabetes, what other elements stress your mother?

Part 4

The crucial problem is the combination of gestational diabetes and obesity. The risks mentioned above are likely to occur on Elena and her baby. The issues and any development will negatively affect- psychologically, physically, and financially- Elena’s family.

Part 5

In developing a nursing diagnosis, a five-phase process is carried out; assessment, diagnosing, planning, implementation, and evaluation.

The best nursing diagnosis for the mother is health promotion. Due to that, body mass index (BMI) tests have already confirmed she is obese – has a BMI of 35. Therefore, the best plan for her to reduce weight is through physical activities and taking a healthy diet. For implementation and evaluation of the plans she will need to seek help from an obstetrician and nutritionist.

Bestowing to Walsh and McAuliffe (2012), fetal macrosomia is highly likely to occur to the fetus if the mother is obese. Nurses caring for Elena ought to measure the fundal height and volume of the amniotic fluid to determine the size of the baby.

Part 6

In most cases, after pregnancy, gestational diabetes disappears; however, at times, it persists and is termed as type II diabetes. Even after it has gone, chances of it recurring is high (Badran & Laber, 2012). The systematic method for diagnosing of this diabetes is through a glycated hemoglobin test. Nonetheless, certain conditions interfere with this testing. The alternatives are to use a random blood sugar test, oral glucose tolerance test, or fasting sugar test. After delivery, it is recommended the blood sugar levels to be tested after the sixth to twelfth weeks. If the results are negative, monitoring should be done in intervals of three years (Mayo Clinic, 2020). To bring about a good prognosis, providers should educate the patients on the risk factors and ways to prevent the rising of sugar levels.

References

Mayo Clinic. (2020, February 27). Gestational diabetes – Diagnosis and treatment. Retrieved March 14, 2020, from https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/diagnosis-treatment/drc-20355345

Walsh, J. M., & McAuliffe, F. M. (2012). Prediction and prevention of the macrosomic fetus. European Journal of Obstetrics & Gynecology and Reproductive Biology, 162(2), 125-130.

Badran, M., & Laher, I. (2012). Type II diabetes mellitus in Arabic-speaking countries. International journal of endocrinology, 2012.