Asian ethnicity is not considered a risk factor. Hispanic, Native American and African American ethnicities are considered risk factors for gestational diabetes. Others include maternal obesity, previous pregnancies with gestational diabetes, delivery of a very large baby, and a family history of diabetes.

The woman is experiencing the first stage labor and the second phase. The first stage of labor exists when the woman's cervix is dilating from 0-10cm. The second phase of the first stage occurs during dilation from 4-7cm and when the cervix is 40-80% effaced. The second stage of labor is when the cervix is dilated 10cm until the delivery of the baby. The third stage of labor is the delivery of the placenta. The first phase of labor is the onset of labor until the cervix is dilated 3cm. The third phase of labor is when the cervix fully dilates from 7cm to 10cm. 

During the third phase of the first stage of labor, the cervix dilates from 8-10 cm and effacement reaches 80-100%. The woman will be less able to focus on other things and may require more support from support persons. Labor may progress quickly and the nurse should be preparing for the second stage of labor, in which the cervix is fully dilated at 10cm. 

Polyphagia (excessive hunger), polydipsia (excessive thirst) and polyuria (excessive urination) are three hallmark signs that point to diabetes. While increased fatigue is common in pregnancy, combined with the other two symptoms, it may be concerning. Pre-eclampsia involves elevated blood pressure, swelling of the hands and feet, and protein in the urine. Toxoplasmosis results from infection by a parasite and can effect fetal development. A amniocentesis is performed to diagnose the infection of the fetus. Depending on the suspected duration of infection and the gestational age, drugs may be administered to decrease the chance of the parasite from infecting the fetus. Anemia, and parvovirus B19 are unlikely to cause all three of these symptoms occurring together.

All those listed may be asthma triggers with the exception of moist air. Typically, cold air may trigger asthma exacerbation. Additional triggers include exercise, respiratory illness, smoke, and mold. 

During pregnancy, many women crave and eat substances that adults do not generally ingest. This condition is normal and is called pica. Often, the substances do not have high nutritional value. Examples are dirt, chalk, rocks, toothpaste, toilet paper, etc. It is important to determine the risks involved with ingesting these materials. For example, the nurse must determine that a woman who is eating dirt does not ingest potting soil mixed with fertilizer and other potentially toxic chemicals.

Late decelerations are caused by uteroplacental insufficiency. The nurse should anticipate many interventions to promote uteroplacental blood flow. Initially, the nurse should implement oxygen supplementation, stop the oxytocin infusion, reposition the mother to the left side, and introduce a fluid bolus of lactated Ringer's solution (LR).

A fetal heart rate (FHR) deceleration occurs when the FHR drops 15 bpm below baseline for a period of 15 seconds when the gestation is more than 32 weeks and 10 bpm below baseline for 10 seconds when gestation is less than 32 weeks. When the onset of the deceleration occurs at the onset of a new contraction and recovers with the end of the same contraction, the strip is demonstrating early decelerations, and the fetus is exhibiting head compression. Late decelerations occur when the deceleration begins after the start of a contraction and does not resolve until after the contraction has finished; late decelerations are the result of uteroplacental insufficiency. A variable deceleration is caused by cord compression, and appears as a brief drop in FHR from baseline that resolves quickly, creating a "V" shape on the strip.

A category II fetal heart rate tracing include all FHR tracings that are not category I or category III. Category I FHR tracings are as follows: baseline 110-160bpm, moderate variability, absent late or variable decelerations, present or absent early decelerations, and present or absent accelerations. Category III FHR tracings are as follows: absent baseline FHR variability, recurrent late decelerations, recurrent variable decelerations, bradycardia, and sinusoidal patterns.

Risk factors for gestational diabetes include: obesity, family history of diabetes, history of gestational diabetes, hypertension, pre-eclampsia/eclampsia, recurrent urinary tract infections, vaginitis, polyhydramnios, previous large infants (9lbs or greater than 4000g), glycosuria or proteinuria on two or more occasions. While poor diet may contribute to diabetic concerns, it is not directly associated with a higher risk of gestation diabetes as the other risk factors are. During the prenatal period, nurses are responsible for educating their patients on all of these risk factors as well as a proper prenatal diet.