Complication by Gestational Diabetes:
You are the newborn nursery nurse and have been called to the labor and delivery suite
to attend the delivery of a G5P4 mother whose pregnancy was complicated by
gestational diabetes. At 2032 a male infant weighing 8 pounds 2 ounces was delivered
vaginally with the assistance of a vacuum extractor. You have assigned Apgar scores of
7 and 9. (Learning Objectives 2, 3, 5, 6, and 8)
1. Relate the assessments you need to carry out in this immediate postdelivery time period.
2. Describe the nursing interventions you will perform before the baby is taken to the newborn
nursery.
3. After taking the baby to the newborn nursery, you notice that the baby has developed diffuse
swelling and bruising on the occiput of his head from the vacuum extractor use. Discuss how
you would differentiate between a cephalhematoma formation and caput succedaneum
development. Which one is more serious?
4. When the baby is 6 hours old, you notice that he has become jittery and is cyanotic. You
check a heel stick blood sugar and it reveals a blood glucose level of 30.
Discuss the immediate nursing interventions you will implement and what additional
interventions you can implement to prevent this from occurring again in the future.
2. Sarah is 19-year-old G1P0 at 36 weeks' gestation. Sarah has been followed weekly in
the clinic for mild–moderate preeclampsia. At her clinic appointment today, Sarah’s
blood pressure reading was 188/104. She is admitted to the antepartum unit for
management of her worsening preeclampsia. You perform her admission assessment
and note that her reflexes are brisk, her heart rate is 94, she complains of having an
intense headache, and is seeing spots before her eyes. You perform an abdominal
assessment and note that she has significant epigastric tenderness. (Learning Objective
5)
1. Develop a plan of care for the woman experiencing preeclampsia, eclampsia, and HELLP
syndrome.
Relate the assessments you need to carry out in this immediate
postdelivery time period.
In the immediate postdelivery time period for a newborn whose mother had gestational diabetes, there
are several assessments you need to carry out. These assessments help determine the baby's overall
well-being and identify any potential complications. Here are the assessments you should perform:
Apgar scoring: You have already assigned Apgar scores of 7 and 9, which provide a quick assessment of
the baby's physical condition immediately after birth. The Apgar score evaluates the baby's heart rate,
respiratory effort, muscle tone, reflex irritability, and color.
Physical examination: Conduct a thorough physical examination of the newborn. This examination
involves assessing the baby's overall appearance, checking for any visible abnormalities, measuring the
baby's weight, length, and head circumference, and observing the baby's muscle tone and reflexes.
Blood glucose level: Due to the mother's gestational diabetes, there is a risk that the baby's blood
glucose level might be low (hypoglycemia) or high (hyperglycemia). Check the baby's blood glucose level
using a glucometer or send a blood sample to the laboratory for analysis if necessary.
Respiratory assessment: Observe the baby's breathing pattern and assess for any signs of respiratory
distress. This is especially important if the baby required the assistance of a vacuum extractor during
delivery.
Temperature assessment: Measure the baby's body temperature to ensure it is within the normal range.
Newborns are susceptible to heat loss, so it's essential to keep them warm and prevent hypothermia.
