A 22-year-old primigravida visits the antepartal clinic in her third month of pregnancy. She has had diabetes mellitus for the past 7 years.
During the visit to the clinic, the nurse and patient discuss diabetes mellitus and pregnancy.Which comment by the patient would indicate a need for further instruction?
I will probably need more insulin as my pregnancy progresses.
I will have to increase my food intake during pregnancy.
Urine testing is the best indication of whether my blood sugar is under control.
Regular exercise will help keep my blood sugar under control.
The Correct Answer is C
The correct answer is choice C. Urine testing is the best indication of whether my blood sugar is under control. This is wrong because urine testing only reflects the blood sugar level at the time of urination, not the current level.
It also does not detect low blood sugar levels (hypoglycemia), which can be dangerous for the mother and the baby.
The best way to monitor blood sugar levels during pregnancy is to use a glucometer, which measures the blood glucose level from a drop of blood.
Choice A is correct because insulin requirements usually increase during pregnancy due to hormonal changes and increased insulin resistance.
The patient may need to adjust her insulin dose according to her blood glucose levels and dietary intake.
Choice B is correct because the patient needs to eat a balanced diet that provides adequate calories and nutrients for herself and the baby.
She may need to consult a dietitian to plan her meals and snacks according to her blood glucose levels and insulin regimen.
Choice D is correct because regular exercise can help lower blood glucose levels, improve insulin sensitivity, and prevent excessive weight gain during pregnancy.
The patient should consult her healthcare provider before starting or changing her exercise routine.
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Correct Answer is B
Explanation
The correct answer is choice B. Insulin amount needs will continue to increase throughout the second and third trimesters.This is because gestational diabetes is a form of diabetes that develops during pregnancy, usually during the 2nd or 3rd trimester.It is caused by hormonal changes that interfere with the action of insulin, leading to high blood sugar levels.As the pregnancy progresses, the placenta produces more hormones that increase insulin resistance, so the mother needs more insulin to keep her blood sugar within normal range.
Choice A is wrong because insulin amount needs will not remain stable during the third trimester.They will increase as the placenta grows and produces more hormones that cause insulin resistance.
Choice C is wrong because insulin amount needs will not decrease during the third trimester.They will increase as the placenta grows and produces more hormones that cause insulin resistance.
Choice D is wrong because insulin amount needs will not remain stable for the rest of the second and during the third trimesters.They will increase as the pregnancy progresses and the placenta produces more hormones that increase insulin resistance.
Normal ranges for blood sugar during pregnancy are: fasting < 95 mg/dL, 1 hour after meal < 140 mg/dL, 2 hours after meal < 120 mg/dL.
Correct Answer is D
Explanation
The correct answer is choice D. Cesarean delivery.A pregnant patient with genital herpes is at higher risk of transmitting the infection to the baby during vaginal delivery, especially if there is an active outbreak near the time of birth.This can cause serious complications for the baby, such as brain damage, eye problems, or even death.Therefore, a cesarean delivery is recommended to avoid contact between the baby and the genital lesions.
Choice A is wrong because forceps-assisted second stage of labor is not a complication of genital herpes.
It is a method of assisted delivery that may be used for various reasons, such as fetal distress, maternal exhaustion, or abnormal presentation.
Choice B is wrong because precipitous delivery, which means a very fast labor and delivery, is not a complication of genital herpes.
It may be caused by factors such as multiparity, strong contractions, or previous rapid deliveries.
Choice C is wrong because prolonged first phase of labor, which means a slow dilation of the cervix, is not a complication of genital herpes.
It may be caused by factors such as ineffective contractions, large fetal size, or malposition.
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