Hesi Case Study: Gestational Diabetes
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Hesi Case Study Gestational Diabetes Exam 2022\2023
1. Meet the Client:: Danielle Greene
Danielle Greene is a 32-year-old multigravida at 28 weeks' gestation, who
presents to the obstetricians office for a routine prenatal visit. She has been
receiving prenatal care since 8 weeks' gestation.
2. Obstetrical History: The clinic nurse reviews Danielle's prenatal record prior
to performing a nursing assessment. Danielle has given birth three times;
once at 35 weeks (twins), once at 38 weeks (singleton) and once at 41 weeks
(singleton). All of these children are alive and well. She had one spontaneous
abortion at 10 weeks' gestation.
3. How should the nurse record Danielle's obstetrical history using the G-T-
P-A-L designation?:
, . Hesi Case Study: Gestational Diabetes
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4. The nurse notes that Danielle's fasting 1-hour glucose screening level,
which was done 1 week prior, is 164 mg/dL: 5-2-1-1-4
5. Which information does the nurse recognize in the client's history to
support a diagnosis of gestational diabetes?: Child weighed 9 lbs (4.08 kg)
at 41 weeks' gestation.
6. Further Glucose Screening: Danielle is scheduled for a 3-hour oral glucose
tolerance test in 5 day and is told to arrive at the lab at 0830. Danielle asks if
there are any special instructions for the test in addition to fasting for 8 hours
immediately prior to the test.
7. Which instruction should the nurse give the client?: Follow an unrestricted
diet and exercise pattern for at least 3 days before the test.
, Hesi Case Study: Gestational Diabetes
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8. Danielle asks the nurse why she wasn't tested for gestational diabetes
until she was at almost 28 weeks' gestation.:
9. The nurse's response should be based on the understanding of which
normal physiologic change of pregnancy?: Hormonal changes in the
second and third trimesters result in increased maternal insulin resistance.
10. Interdisciplinary Client Care: Danielle's 3-hour oral glucose tolerance test
indicates that she does have gestational diabetes. The nurse phones Danielle
and arranges for her to meet with the obstetrician, as well as an RN diabetes
educator and a registered dietician (RD) the next day.
The obstetrician and the nurse discuss gestational diabetes with Danielle. After
seeking Danielle's input, they outline their suggested POC, which includes
dietary control and glucose self-monitoring. After the obstetrician leaves,
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