A client with diet controlled gestational diabetes mellitus arrives for a routine appointment at the prenatal clinic. The client's glycosylated hemoglobin (HbA1C) is 5%. Which action should the nurse take? Reference Range: Glycosylated hemoglobin (HbA1C) [4% to 5.9% ]

Rationale: A. Continue with the current diabetic plan of care: A glycosylated hemoglobin (HbA1C) of 5% is within the normal reference range for pregnant clients and indicates good blood glucose control. Maintaining the current diet-controlled management plan is appropriate, with ongoing monitoring to ensure continued stability. B. Refer the client to the diabetic educator: Referral to a diabetic educator is important for clients struggling with glucose control or requiring insulin management. Since this client’s HbA1C is within the target range and diet-controlled management is effective, referral is not immediately necessary. C. Administer prescribed subcutaneous insulin: Insulin administration is indicated when diet and lifestyle measures fail to maintain adequate blood glucose control. The client’s HbA1C of 5% demonstrates effective glucose management without the need for pharmacologic intervention. D. Obtain a 24 hour urine collection for total protein: A 24-hour urine collection is used to assess for proteinuria, which is a marker of preeclampsia, not a routine follow-up for gestational diabetes with well-controlled blood glucose.