I believe Elsevier has changed their format, in that you have to have individual passwords now to access the Evolve textbook sites
Nursing diagnosis: Alteration in Carbohydrate Metabolism related to diabetes.
Not a true NANDA-approved nursing dx.
Nursing diagnosis: Altered Tissue Perfusion: uteroplacental, related to diabetes in pregnancy.
Risk for Ineffective Tissue Perfusion (uteroplacental) r/t possible premature aging of placenta and exchange problems secondary to gestational diabetes mellitus (need to be specific about the gestational diabetes, since there is another type of diabetes in pregnancy - preexisting).
Other possible physical diagnoses:
Risk for Maternal Injury or
Risk for Fetal Injury r/t difficult birth of large-for-gestational-age infant (macrosomia) secondary to poorly-controlled gestational diabetes mellitus
Risk for Newborn Injury (hypoglycemia) r/t to high fetal serum insulin levels secondary to high maternal glucose levels (poorly-controlled gestational diabetes mellitus)
Risk for Newborn Impaired Gas Exchange r/t possible inadequate stores of surfactant and possible immaturity of fetal lungs secondary to poorly-controlled gestational diabetes mellitus
Nursing diagnosis: Anxiety related to disease process.
OK, but a much better psychosocial would be Deficient Knowledge (disease process of gestational diabetes) r/t lack of exposure, information misinterpretation, or unfamiliarity with information resources
Another psychosocial: Ineffective Therapeutic Regimen Management