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