What should a nurse monitor when caring for a client with gestational diabetes?

Monitoring maternal blood glucose levels is crucial for a client with gestational diabetes because it helps ensure that the mother's glucose levels remain within a target range, which is necessary for the health of both the mother and the developing fetus. Uncontrolled blood glucose can lead to complications such as macrosomia, neonatal hypoglycemia, and increased risk of cesarean delivery. Regular monitoring allows for timely interventions, including dietary adjustments, insulin therapy if necessary, and risk assessment for potential complications.

The other choices, while important in their own contexts, do not focus directly on the immediate concern of managing gestational diabetes and its impact on maternal and fetal health. Fetal heart rate variability is significant but typically monitored in the context of fetal health rather than as a direct response to the mother's glucose levels. Dietary calorie intake is important, but the primary concern is how those calories influence blood glucose levels. Folic acid supplementation is a critical aspect of preconception and early pregnancy care, but it does not address the specific complications arising from gestational diabetes. Thus, monitoring maternal blood glucose levels directly addresses the primary health concern in this situation.