(To be used in conjunction with customary postpartal plans of care.)
CLIENT ASSESSMENT DATA BASE
(Refer to CP: Diabetes Mellitus: Prepregnancy/Gestational; and CP: Intrapartal Diabetes
Mellitus.)
Activity/Rest
Fatigue, especially when labor was long or difficult (increases glucose needs)
Circulation
May have elevated BP, edema (signs of PIH that developed during prenatal, intrapartal, or postpartal period
History of vascular changes associated with diabetes that impair circulation/kidney functioning; venous thrombosis
Elimination
Polyuria
Food/Fluid
Polydipsia, polyphagia
Nausea/vomiting
Ketonuria, elevated serum glucose
May report episodes of hypoglycemia, glycosuria
Safety
Healing of episiotomy or cesarean incision may be delayed.
May report visual disturbances.
Sexuality
Uterus may be relaxed/boggy, and lochia may be heavy with clots present.
Current pregnancy may have involved uterine overdistension (macrosomia or hydramnios).
Labor may have been prolonged/augmented or induced.
Preterm, large-for-gestational age, or low-birth-weight infant.
Teaching/Learning
Change in stability of diabetes, adjustment of insulin therapy.
Type of infant feeding planned affects caloric needs and insulin requirements.
DIAGNOSTIC STUDIES
Fasting (Daily) or serum Glucose: Assesses control (increased risk of hypoglycemia).
Hb/Hct: Baseline studies.
Glycosylated Hemoglobin (HbA1c): May be elevated (greater than 8.5%), indicating inadequate control of serum glucose levels.
Urinalysis: May show glucose, ketones, or protein.
NURSING PRIORITIES
1. Maintain normoglycemia.
2. Prevent or minimize complications.
3. Promote parent-infant bonding.
4. Provide information concerning postpartal changes and diabetic management.
discharge criteria
Gestational Diabetes
1. Regains euglycemia without need of medication
2. Understands nature of condition and prognosis for future
Diabetes
Because this is a life-long condition, client’s care will be transferred to primary care provider at completion of postpartum period.
CLIENT ASSESSMENT DATA BASE
(Refer to CP: Diabetes Mellitus: Prepregnancy/Gestational; and CP: Intrapartal Diabetes
Mellitus.)
Activity/Rest
Fatigue, especially when labor was long or difficult (increases glucose needs)
Circulation
May have elevated BP, edema (signs of PIH that developed during prenatal, intrapartal, or postpartal period
History of vascular changes associated with diabetes that impair circulation/kidney functioning; venous thrombosis
Elimination
Polyuria
Food/Fluid
Polydipsia, polyphagia
Nausea/vomiting
Ketonuria, elevated serum glucose
May report episodes of hypoglycemia, glycosuria
Safety
Healing of episiotomy or cesarean incision may be delayed.
May report visual disturbances.
Sexuality
Uterus may be relaxed/boggy, and lochia may be heavy with clots present.
Current pregnancy may have involved uterine overdistension (macrosomia or hydramnios).
Labor may have been prolonged/augmented or induced.
Preterm, large-for-gestational age, or low-birth-weight infant.
Teaching/Learning
Change in stability of diabetes, adjustment of insulin therapy.
Type of infant feeding planned affects caloric needs and insulin requirements.
DIAGNOSTIC STUDIES
Fasting (Daily) or serum Glucose: Assesses control (increased risk of hypoglycemia).
Hb/Hct: Baseline studies.
Glycosylated Hemoglobin (HbA1c): May be elevated (greater than 8.5%), indicating inadequate control of serum glucose levels.
Urinalysis: May show glucose, ketones, or protein.
NURSING PRIORITIES
1. Maintain normoglycemia.
2. Prevent or minimize complications.
3. Promote parent-infant bonding.
4. Provide information concerning postpartal changes and diabetic management.
discharge criteria
Gestational Diabetes
1. Regains euglycemia without need of medication
2. Understands nature of condition and prognosis for future
Diabetes
Because this is a life-long condition, client’s care will be transferred to primary care provider at completion of postpartum period.
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