A laboring woman with Type 1 diabetes is on an IV insulin drip, and the nurse is monitoring her glucose levels hourly. The woman's partner asks why the glucose needs to remain between 70-110 mg/dL. The nurse's response is based on which of the following information?

Maintaining euglycemia in labor reduces the need for insulin postpartum.

A blood glucose level 110 puts the client at risk for infection in labor.

More insulin will be available for fetal use via placental transfer.

An elevated blood glucose in labor increases the risk of neonatal hypoglycemia.

Answer and Explanation

The Correct Answer is D

A. Maintaining euglycemia in labor reduces the need for insulin postpartum. While insulin requirements typically decrease after delivery due to the loss of placental hormones that cause insulin resistance, the primary reason for tight glucose control during labor is to prevent neonatal complications rather than reducing postpartum insulin needs.

B. A blood glucose level above 110 puts the client at risk for infection in labor. Poorly controlled diabetes can increase infection risk over time, but transient hyperglycemia in labor is not a direct cause of infection. The focus of glucose management during labor is to prevent neonatal hypoglycemia rather than maternal infection.

C. More insulin will be available for fetal use via placental transfer. Insulin does not cross the placenta, so maternal insulin therapy does not provide insulin to the fetus. However, maternal hyperglycemia leads to increased fetal insulin production, which can cause neonatal hypoglycemia after birth.

D. An elevated blood glucose in labor increases the risk of neonatal hypoglycemia. Maternal hyperglycemia causes the fetus to produce excessive insulin in utero. After birth, when the maternal glucose supply is suddenly cut off, the infant’s high insulin levels can cause a rapid drop in blood glucose, leading to neonatal hypoglycemia, which can be dangerous if not managed properly.

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Correct Answer is ["B"]

Explanation

A. Transverse fetal lie. A transverse fetal lie is related to fetal positioning and is not a direct complication of trauma. While maternal injuries can sometimes lead to abnormal fetal positioning, a car accident does not directly cause a transverse lie.

B. Preterm labor. Trauma, including a car accident, can trigger preterm labor due to stress, uterine irritation, or placental dysfunction. Uterine contractions may begin as a response to the injury, potentially leading to preterm birth.

C. Severe preeclampsia. Preeclampsia is not a direct result of trauma. It is a pregnancy-related hypertensive disorder that develops due to vascular abnormalities rather than external injury. A car accident does not increase the risk of preeclampsia.

D. Placenta previa. Placenta previa is a condition where the placenta covers the cervix, leading to painless vaginal bleeding, but it is not caused by trauma. It is a pre-existing placental abnormality rather than a complication of an auto accident.

E. Placental abruption. Trauma, such as a car accident, significantly increases the risk of placental abruption, where the placenta prematurely detaches from the uterine wall. This can cause vaginal bleeding, abdominal pain, and fetal distress, making it a critical complication to monitor for in a pregnant trauma patient.

A. There is progressive resistance to the effects of insulin B. Pregnancy fosters the development of carbohydrate cravings. C. Hypoinsulinemia develops early in the first trimester D. Glucose levels decrease to accommodate fetal growth.

Correct Answer is A

Explanation

A. There is progressive resistance to the effects of insulin. During pregnancy, placental hormones (such as human placental lactogen, estrogen, and progesterone) cause increasing insulin resistance. This ensures that glucose remains available for fetal growth. However, in gestational diabetes, the pancreas cannot compensate with increased insulin production, leading to hyperglycemia.

B. Pregnancy fosters the development of carbohydrate cravings. While some pregnant individuals experience cravings, this is not a defining cause of gestational diabetes. The condition results from hormonal changes leading to insulin resistance, not dietary habits alone.

C. Hypoinsulinemia develops early in the first trimester. Gestational diabetes is not caused by a deficiency of insulin (hypoinsulinemia) but by insulin resistance. In fact, insulin production often increases, but it is insufficient to overcome the resistance caused by placental hormones.

D. Glucose levels decrease to accommodate fetal growth. In a normal pregnancy, glucose levels remain stable, and the fetus actively takes glucose from maternal circulation. However, in gestational diabetes, maternal glucose levels rise due to insulin resistance, increasing the risk of fetal overgrowth (macrosomia).

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A laboring woman with Type 1 diabetes is on an IV insulin drip, and the nurse is monitoring her glucose levels hourly. The woman's partner asks why the glucose needs to remain between 70-110 mg/dL. The nurse's response is based on which of the following information?

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Naxlex Comprehensive Predictor Exams

A pregnant woman is just admitted to the emergency room after a head on auto accident. Her body appears to be uninjured. The nurse carefully monitors the woman for which complication(s) of pregnancy? (Select all that apply)

Correct Answer is ["B"]

Explanation

The nurse would include which of the following statements when describing the pathophysiology of gestational diabetes?

Correct Answer is A

Explanation

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