Passage / Scenario

Vital Signs: Heart rate: 80/min, Temperature: 37.2°C (99°F), Blood pressure: 120/80 mm Hg, Respiratory rate: 18/min. Diagnostic Results: January 8 / 0900: Oral Glucose Tolerance Test with 75-g glucose load - 190 mg/dL (Normal: less than 180 mg/dL). February 8 / 0900: Fasting: 110 mg/dL (Normal: less than 110 mg/dL), 1000: 220 mg/dL (Normal: less than 180 mg/dL), 1100: 165 mg/dL (Normal: less than 140 mg/dL), 1200: 142 mg/dL (Normal: 70 to 115 mg/dL). Nurses' Notes: On January 8 at 0900, the fundal height was measured at 22 cm and fetal heart tones were 150/min. On February 8 at 0900, the fundal height was measured at 27 cm and fetal heart tones were 145/min. The client reports positive fetal movement, denies abdominal cramping, vaginal bleeding, and leaking of fluids. The client also denies headaches, visual disturbances, and epigastric pain. History and Physical: The client is a 32-year-old female, gravida 2 para 1, with a history of gestational diabetes mellitus (GDM) during her previous pregnancy. She is currently at 28 weeks of gestation. The client reports no other significant medical history. She is adhering to a diabetic diet and taking insulin as prescribed.