SUBJ.

DATA: Activity  To assess patient’s level of  patient’s level of tolerance of Patient is able to
intolerance r/t tolerance of activity. activity assessed. do self care acivity
Patient c/o increased and takes
weakness and energy adequate rest and
 To encourage to do self activity  Encouraged to do self activity
fatigue and demands due sleep.
reduced self to disease
care activity. condition and
increased fetal  To advise rest in between periods  Advised rest in between periods of
OBJ. DATA: nutrient of activity activity
uptake.
Patient looks
 To advise to take night sleep of 6-  advised to take night sleep of 6-8
dull and activity
8 hours hours
is limited.

 Provide dietary information  dietary information Provided about

about sources of iron and the sources of iron and the need for
need for iron supplements. iron supplements.

 Provide information about need  Information Provided about need

for regular daily mild exercise for regular daily mild exercise
program (regularly, 20 min after program (regularly, 20 min after
meals). Warn against exercising if meals). Warn against exercising if
glucose exceeds 300 mg/dL. glucose exceeds 300 mg/dL.

 Provide information regarding  information Provided regarding the

the impact of pregnancy on the impact of pregnancy on the
diabetic condition and future diabetic condition and future
 expectations. expectations.

SUBJ DATA: Risk for fetal  To Determine white’s  fetal movement and fetal heart Display normally
injury r/t classification for diabetes, rate monitored and FHS is reactive NST and
Nil elevated  To assess for fetal movement and 132beats/min negative CST.
serum glucose fetal heart rate.  client encouraged to count and
OBJ DATA: levels and  To encourage client to count and record periodically fetal
consequent record periodically fetal movements, beginning about 18
Blood glucose changes in movements, beginning about 18 weeks of gestation and daily from
levels: circulation. weeks of gestation and daily from 34 weeks onward.
34 weeks onward.  fundal height is 32-34 weeks.
FBS-155mg/dl  To measure fundal height each  information provided about
visit. possible effect of diabetes on fetal
PP-204mg/dl  To Provide information about growth and development.
possible effect of diabetes on  procedure and rationale for
HbA1c-9.3 fetal growth and development. periodic NSTs (e.g., weekly NST
 To Review procedure and after 30 weeks’ gestation, twice-
rationale for periodic NSTs (e.g., weekly NST after 36 weeks’
weekly NST after 30 weeks’ gestation) reviewed with client.
gestation, twice-weekly NST after  procedure and rationale for
36 weeks’ gestation). periodic OCTs BEGINNING AT 30-
 To Review procedure and 32 WEEKS gestation. reviewed with
rationale for periodic OCTs client.
BEGINNING AT 30-32 WEEKS  signs of PIH (edema, proteinuria,
gestation. increased blood pressure)
 To Monitor for signs of PIH monitored.
(edema, proteinuria, increased
 blood pressure).  No ketone bodies in urine .
 To Monitor urine for ketones.
Note fruity breath
SUBJ. DATA: Knowledge  Assess client’s/couple’s  client’s/couple’s knowledge of Participate in the
deficit r/t knowledge of disease process and disease process and treatment, management of
Mother asks diabetic treatment, including relationships including relationships between diabetes during
questions condition, between diet, exercise, illness, diet, exercise, illness, stress, and pregnancy.
regarding how prognosis, and stress, and insulin requirements. insulin requirements assessed. Verbalize
long to self care  Discuss importance of home  importance of home serum glucose understanding of
continue insulin treatment serum glucose monitoring using monitoring using reflectance the procedures,
therapy. needs reflectance meter, and the need meter, and the need for frequent laboratory tests,
for frequent readings (at least 4 readings (at least 4 times/day), as and
OBJ. DATA: times/day), as indicated. indicated discussed. activities involved
 Demonstrate procedure, observe  Demonstrate procedure, observe in controlling
Client looks return demonstration by the return demonstration by the client. diabetes.
confused about client.  reasons explained why oral Demonstrate
insulin therapy  Review reasons why oral hypoglycemic medications should proficiency in self-
and oral hypoglycemic medications should be avoided, monitoring and
hypoglycemic be avoided, to control diabetes  Information provided about insulin
agents. before pregnancy. action and adverse effects of administration.
 Provide information about action insulin. Client assisted to learn
and adverse effects of insulin. administration by injection,
Assist client to learn  Recommend client maintain a diary
administration by injection, of home assessment of serum
insulin pump, or nasal spray as glucose levels, insulin dosage, diet,
indicated. exercise, reactions, general
 Recommend client maintain a feelings of well-being, and any
diary of home assessment of other pertinent thoughts.
serum glucose levels, insulin
dosage, diet, exercise, reactions,
general feelings of well-being,
and any other pertinent thoughts
 

Mother Anxiety r/t  To assess patients level of  patients level of anxiety assessed. Mother shows
verbalizes her outcome of anxiety. less anxiousness
concern for her pregnancy and  To the ways to improve pregnancy about the
baby as her health of  To discuss with mother the ways outcome like by regular antenatal outcome of
previous two unborn child to improve pregnancy outcome checkup , maintained blood labour.
deliveries were as witnessed like by regular antenatal checkup glucose levels within normal range,
still birth. by mother’s etc. consuming diabetic diet. discussed
frequent
doubts about with mother
pregnancy
outcome.
 To allow mother to ask questions
and ventilate her feelings  mother allowed to ask questions
and ventilate her feelings
 Assess client’s/couple’s
knowledge of disease process and  client’s/couple’s knowledge of
treatment, including relationships disease process and treatment,
between diet, exercise, illness, including relationships between
stress, and insulin requirements. diet, exercise, illness, stress, and
insulin requirements assessed.
 To involve family members in
care of the client.  family members involved in care of
 To educate the mother about the client.
maternal as well as fetal hazards
of gestational diabetes and hence  the mother educated about
educate her to maintain her maternal as well as fetal hazards of
serum glucose levels within gestational diabetes.
normal range.
Prepare for hospitalization if diabetes is
not controlled.

 Teach/review method to self

monitor blood glucose.
.

Assess understanding of the effect of

stress on diabetes. Provide information
about stress management and
relaxation.