A nurse is caring for a client who is at 37 weeks of gestation and diagnosed with placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

Explanation:

A. Acarbose:

Acarbose is an oral antidiabetic medication that works by slowing down the digestion and absorption of carbohydrates in the intestines. It is typically used in the management of type 2 diabetes but is not commonly prescribed for gestational diabetes mellitus (GDM). Acarbose is not usually recommended during pregnancy, especially since there are other safer options available for managing GDM.

B. Repaglinide:

Repaglinide is another oral antidiabetic medication that stimulates insulin release from the pancreas. While it is effective in lowering blood sugar levels, it is not commonly used as a first-line treatment for gestational diabetes. Repaglinide may have a more rapid onset of action compared to other oral antidiabetic drugs, but its use during pregnancy is not as common as other medications like glyburide or insulin.

C. Glipizide:

Glipizide is an oral sulfonylurea medication used primarily in the management of type 2 diabetes. It stimulates insulin secretion from the pancreas. However, like other sulfonylureas, glipizide is not typically recommended for use during pregnancy due to safety concerns for the developing fetus. It may also have a higher risk of hypoglycemia compared to other options.

D. Glyburide:

Glyburide is an oral sulfonylurea medication that helps lower blood sugar levels by stimulating insulin release from the pancreas. It is one of the commonly used medications for managing gestational diabetes when diet and exercise alone are not sufficient. Glyburide is generally considered safe for use during pregnancy, especially after the first trimester, and it has been found to effectively control blood glucose levels in many pregnant individuals with GDM.

Explanation:

A. "You will need to double your intake of iron during pregnancy."

This statement is not accurate. While iron needs do increase during pregnancy to support the increased blood volume and fetal development, the recommended increase is not necessarily a doubling of intake. Specific iron requirements can vary based on individual factors, such as pre-pregnancy iron status and maternal health conditions.

B. "Prenatal vitamins will meet your need for increased vitamin D during pregnancy."

Prenatal vitamins typically contain some vitamin D, but they may not meet the increased need for vitamin D during pregnancy entirely, especially if the client has limited sun exposure or other risk factors for vitamin D deficiency. Additional sources of vitamin D, such as sunlight exposure and dietary sources, may be recommended.

C. "You will need to increase your calcium intake during breastfeeding."

This statement is correct. During breastfeeding, calcium requirements increase to support milk production and the maintenance of maternal bone health. Adequate calcium intake is important for both the mother and the growing infant.

D. "Vitamin E requirements decline during pregnancy due to the increase in body fat."

This statement is not accurate. Vitamin E requirements do not necessarily decline during pregnancy because of an increase in body fat. Vitamin E is still essential during pregnancy for its antioxidant properties and role in fetal development.