Concept explainers
To determine: Whether Person E is resistant to insulin or not.
Introduction: Gestational diabetes is an abnormality characterized by an increase in the blood glucose level during pregnancy. It is more likely to develop in women after 35 year-old and who is obese. Various other factors like lack of physical activity, unhealthy diet, and polycystic ovarian syndrome or previous history of the disease in earlier pregnancies/ family history are also found in cases as the leading cause of the disease.
The diagnosis of the disease is based on the estimation of glucose level in the blood as recommended by the American Diabetes Association and its management basically involves maintaining a healthy lifestyle with the aim of reducing the blood glucose.
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Nutrition Through The Life Cycle
- Meghan is a 33-year-old Filipina at her 28th week of 2nd pregnancy. She called for her obstetrician’s visit due to “flu” symptoms. Records for this visit showed that she stood at 4 feet 11 inches tall and weighed 145 lb. She had a routine glucose challenge test performed and it was noted at 662 mg/dL. A random glucose completed 1–2 days later showed to be at 500 mg/dL. A follow-up HbA1c was at 11.6%. Meghan presented to her obstetrician 3 days after the HbA1c was drawn for ongoing evaluation of hyperglycemia and was advised to rest and take fluids. With the persistent “on-and-off flu-like” symptoms for 3-4 weeks which now included nausea, polyuria, and polydipsia, Meghan presented herself at the Emergency Department. She also added she needs to catch her breath most of the time. Additional symptoms included a 23-lb weight loss over the past 3–4 weeks. Here, she was ordered for CBG and urinalysis. Serum potassium level of 3.35mEq/L. Meghan was immediately started on an insulin…arrow_forwardBoy Andriyko, 9 months old child, is at a routine check-up. Andriyko was born from 1 pregnancy, 1 delivery with a body weight of 2800 g, body length of 48 cm. In 1 month the child's weight was 3400 g, body length - 51 cm. At 2 months - 4200 g, body length was 54 cm. At this age, Andriyko suffered an intestinal infection and was hospitalized. In 4 months the child's weight was 5100 g, body length - 59 cm. At 5 months, the child's weight was 5700 g, body length - 61 cm. At 6 months, the weight is 6500 g, the body length is 63 cm. At 7 months, the child's weight was 7200 g, body length - 65 cm. Give an assessment of the child's physical development with World Health Organization using these charts .arrow_forwardTeresa's body mass index (BMI) is 23.Based on this information, what should the nurse recommend to Teresa in terms of an overall weight gain and the specific weight gain pattern for each trimester? Describe the process that the nurse should use to help Teresa maintain an appropriate intake of foods and fluids during pregnancy.arrow_forward
- At 37 years of age, Señora Mendez was in her 23rd week of pregnancy and expecting her second child. Or so she thought, until an ultrasound scan detected twins. Her prepregnancy weight was 142 pounds (64.5 kg) and her BMI. Señora Mendez’s weight-gain progress has been poor due to nausea and vomiting experienced in the first half of pregnancy. Otherwise, Sra. Mendez was experiencing a normal pregnancy for women expecting twins. Concerns about her weight-gain progress and the nutritional needs of women with twin gestation prompted her certified–nurse midwife to prescribe a prenatal vitamin and mineral supplement and to refer her to a registered dietitian/certified diabetes educator. A nutritional assessment completed during week 25 of pregnancy identified that Sra. Mendez had gained 14 pounds since conception, and that her typical dietary intake excluded food sources of EPA and DHA. Her plasma 25-hydroxyvitamin D level was below 24 nmol/L, indicating low vitamin D status. No other…arrow_forwardMaha is a 24-year-old office manager and part-time aerobics instructor who has delivered vaginally, without complications, a healthy, full-term son, Rani. With a birthweight of 3200 grams (7 lb), Rani is the first child for Maha and her husband. Maha is 162 cm(5 ft 4 in) tall with a prepregancy weight of 56.8 kg (125 lb). She gained 25 kg (55 lb) during her uncomplicated pregnancy and has been a lacto-ovo vegetarian for 5 years. After a 12-hour stay in a birthing center, Maha and her husband bring Rani home. At 4 days postpartum, Maha, her husband, and her mother-in-law bring the baby to the health care center for his first follow-up visit. Maha and her husband are very concerned about whether their son is getting adequate nourishment, so the dietitian is called to see the family. During nutrition assessment, the following information is documented. Rani weighs 3,000 grams (6 lb 6 oz). The parents report that Rani nurses vigorously about every 1½ to 2 hours and never sleeps for more…arrow_forwardA G1P0 pregnant client presents at the prenatal clinic: What is the Expected Date of Delivery (EDD) using Naegele’s Rule for a woman who has had their Last Menstrual Period (LMP) on: LMP: January 15, 2020arrow_forward
- L.H. is a 26-year-old woman is in the clinic today for evaluation of weight gain and fatigue. She is 5 feet 6 inches and weighs 175 pounds. Prior to her pregnancy, she weighed 130 pounds and her maximum weight during pregnancy was 155 pounds. She is now 18 months postpartum and continuing to gain weight despite no change in diet or activity. She reports that the fatigue is getting worse even though her daughter is sleeping reliably through the night and the patient feels she is getting plenty of rest. She takes no other medications and has no significant medical history. Her vital signs today are HR 68, BP 108/60, RR 10, temperature 97° F Select a potential diagnosis for L.H. and describe the pathophysiology of that diagnosis. How does the pathophysiology explain L.H.’s symptoms?arrow_forwardGinger is a 60 year-old retired school teacher. She’s previously been diagnosed with CKD and has a current eGFR of 52 ml/min and her serum creatinine is 1.27 ml/dl. Ginger is 65” tall and weighs 156 lbs. She is working with a registered clinical dietician to manage her nutrient intake and eating habits. She is taking her Plendil as prescribed. Prior to beginning an exercise program, Ginger underwent a GXT. She achieved a maximum exercise capacity of 6 METs, a HRmax of 164 beats/min and demonstrated normal hemodynamic responses to exercise of increasing intensity. Over the last several weeks, Ginger has been regularly exercising in your clinical wellness facility. When she is not exercising, she enjoys gardening and walking in her neighborhood park with friends. She has been recording her resting heart rate and blood pressure before each exercise session. Her average resting heart rate is 68 beats/min and blood pressure is114/72 mmHg. Her resting measurements have not varied widely…arrow_forwardIdentify the exposures and outcomes from the following statements and match as appropriate. (There are more options than needed). Researchers are interested to know whether laws prohibiting texting while driving have led to a reduction in road traffic accidents. Regular intake of fish that are rich in mercury during pregnancy could lead to nervous system damage of the fetus Neural tube defects in the fetus can be prevented by regular folic acid supplementation in women who are pregnant and/or planning to be pregnant As a researcher, you are curious…arrow_forward
- Betty Cooper, 25-y/o-female, is admitted to the emergency department with decreasing level of consciousness. She is 98lbs and stands at 5ft. She has a history of diabetes mellitus since she was 9 years of age. A physical assessment and laboratory data reveal the following:➢ Dry skin, poor turgor > Serum glucose = 504mg/dl➢ RR = 40cpm, rapid and deep & labored > Serum Na = 130 mEq/L➢ HR = 118bpm, weak pulse > Serum K = 5 mEq/L➢ Temp = 98°F > Serum Cl = 108 mEq/L ➢ BP = 110/70 mmHg > BUN = 74.68 mg/dL➢ ABG: pH = 7.15; HCO3; 13mEq/L; pCO2 = 35 mEq/L1. Calculate Betty’s serum osmolality. 2. What type of diabetes mellitus does Betty possibly have? Why? 3. Which complication of diabetes mellitus does Xia possibly have, diabetic ketoacidosis or hyperglycemic hyperosmolar state? Why? 4. What is the 1st priority nursing management and medical management? Why?arrow_forwardDiscuss the statement “ A pregnant woman must eat for two". Please discuss thoroughly.arrow_forwardLavonne is 42-years-old and has always had to watch her intake and maintain an active lifestyle to stay at a healthy weight. She is 5'8" tall and until a couple of months ago, maintained a healthy weight of 160 pounds, with a BMI in the normal range of 24.3. However, a couple of months ago, Lavonne was training for her first marathon and while running, she stepped in a hole and broke her ankle. She has been unable to keep up her training regimen and is very disappointed that she can't participate in the marathon. Lavonne has been indulging in her favorite foods to make herself feel a little better and has gained 18 pounds and her BMI is now 27.1. She's also discovered that as she gains weight, the weight seems to be settling in her middle as her waist circumference has increased by two full inches to 34"! Question 1: Define energy balance and explain Lavonne's weight gain in terms of factors affecting energy intake and all areas of energy expenditure.arrow_forward
- Nutrition Through The Life CycleHealth & NutritionISBN:9781337919333Author:Brown, Judith E.Publisher:Cengage Learning,Nutrition Through the Life Cycle (MindTap Course ...Health & NutritionISBN:9781305628007Author:Judith E. BrownPublisher:Cengage Learning