A new mother who is breastfeeding her 4-week-old infant and has type 1 diabetes, reports that her insulin needs have decreased since the birth of her child. Which action should the nurse implement?

Schedule an appointment for the client with the diabetic nurse educator.

Counsel her to increase her caloric intake

Inform her that a decreased need for insulin occurs while breastfeeding

Advise the client to breastfeed more frequently

Answer and Explanation

The Correct Answer is C

A. Schedule an appointment for the client with the diabetic nurse educator:
This could be a helpful action. The diabetic nurse educator can provide valuable support and education on managing insulin needs during breastfeeding.

B. Counsel her to increase her caloric intake:
While adequate nutrition is essential, increasing caloric intake may not be the primary factor affecting insulin needs. It's important to consider the specific needs of the client, and any adjustments to insulin should be made based on careful monitoring.

C. Inform her that a decreased need for insulin occurs while breastfeeding:
This is accurate information. Breastfeeding can lead to a decreased need for insulin in some individuals. The nurse should provide education on this aspect of managing diabetes during breastfeeding.

D. Advise the client to breastfeed more frequently:
While breastfeeding frequency can impact insulin needs, it's essential to consider the overall picture. Simply increasing breastfeeding frequency may not be the only factor affecting insulin requirements.

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Correct Answer is B

Explanation

A. Bleeding tendencies:
Bleeding tendencies are not typically a priority immediately after birth unless there is a specific indication. Newborns are not at immediate risk for bleeding unless there are underlying conditions.

B. Heat loss:
Heat loss is a significant concern for newborns. Maintaining an adequate temperature is crucial to prevent hypothermia, which can lead to complications.

C. Hypoglycemia:
While monitoring blood glucose is important in the newborn, it may not be the most immediate concern within the first minutes after delivery. Stabilizing the newborn's temperature and initiating breathing are usually higher priorities.

D. Fluid balance:
Fluid balance is essential, but the initial focus is often on establishing respirations and maintaining temperature. Fluids may be administered as needed based on the clinical assessment.

A. Discuss options for intrauterine surgical correction of congenital defects. B. Inform her that a repeat alpha-fetoprotein (AFP) should be evaluated. C. Reassure the client that the AFP results are likely to be a false reading. D. Explain that a sonogram should be scheduled for definitive results

Correct Answer is D

Explanation

A. Discuss options for intrauterine surgical correction of congenital defects:At this point, the AFP result is only an indicator, not a diagnosis. The client has not undergone sufficient diagnostic evaluation (such as ultrasound) to confirm any congenital defect that would warrant intrauterine surgery. Treatment options can only be discussed once a definitive diagnosis has been made.

B. Inform her that a repeat alpha-fetoprotein (AFP) should be evaluated:While a repeat AFP test could be done in some cases to rule out lab error or confirm the result, this is not typically the immediate next step. An ultrasound provides more definitive and comprehensive information than simply repeating the AFP test.

C. Reassure the client that the AFP results are likely to be a false reading:Providing false reassurance may lead to misunderstandings. While false positives can happen, it's crucial to follow up with further assessments to ensure the accuracy of the results.

D. Explain that a sonogram should be scheduled for definitive results:An elevated AFP level is a screening test, not a definitive diagnosis. A sonogram (ultrasound) is the next step to obtain more detailed information about the fetus. Ultrasound can help assess for neural tube defects, confirm gestational age, and check for other anomalies that could explain the elevated AFP levels. This provides the most accurate and non-invasive method for evaluating potential fetal abnormalities.

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A new mother who is breastfeeding her 4-week-old infant and has type 1 diabetes, reports that her insulin needs have decreased since the birth of her child. Which action should the nurse implement?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

Explanation

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