A patient at 24 weeks of gestation says she has a glass of wine with dinner every evening. The nurse will counsel her to eliminate all alcohol intake because:

Choice A reason: Further testing will not be performed to determine the meaning of this score, as the biophysical profile score is a reliable indicator of fetal well-being. It is a combination of five parameters: fetal breathing movements, fetal movements, fetal tone, amniotic fluid volume, and fetal heart rate. Each parameter is scored as 0 (abnormal) or 2 (normal), and the total score ranges from 0 to 10.

Choice B reason: The test results are within normal limits, as a biophysical profile score of 8 or higher indicates a healthy fetus with a low risk of hypoxia or acidosis. It also suggests that the placenta is functioning adequately and the pregnancy can continue safely.

Choice C reason: An obstetric specialist will not evaluate the results of this profile and, within the next week, will inform you of your options regarding delivery, as the biophysical profile score is interpreted by the nurse or the health care provider who performed the test. It is not a diagnostic test that requires a consultation with a specialist.

Choice D reason: Immediate delivery by cesarean birth is not being considered, as the biophysical profile score of 8 does not indicate any fetal distress or complication that would warrant an urgent intervention. Cesarean birth may be indicated for other reasons, such as malpresentation, placenta previa, or failure to progress in labor.

Choice A reason: This is not the correct answer, as the pregnant woman does not use glucose at a more rapid rate than the nonpregnant woman. In fact, the pregnant woman has lower fasting glucose levels and higher postprandial glucose levels than the nonpregnant woman. This is because the pregnant woman adapts to the increased fetal demand for glucose by increasing her insulin secretion and decreasing her hepatic glucose production.

Choice B reason: This is the correct answer, as placental hormones are antagonistic to insulin, thus resulting in insulin resistance. Insulin resistance is a condition where the cells do not respond well to insulin and require more insulin to maintain normal glucose levels. Placental hormones, such as human placental lactogen, progesterone, and cortisol, increase the insulin resistance of the maternal tissues, especially in the second and third trimesters of pregnancy. This is to ensure that the fetus has enough glucose supply, as the placenta is not insulin resistant and can transport glucose to the fetus².

Choice C reason: This is not the correct answer, as pancreatic function in the islets of Langerhans is not affected by pregnancy. The islets of Langerhans are clusters of cells in the pancreas that produce hormones, such as insulin and glucagon, that regulate glucose metabolism. Pregnancy does not impair the function of the islets of Langerhans, but rather stimulates them to increase their size and number. This is to compensate for the increased insulin resistance and glucose demand of the pregnancy.

Choice D reason: This is not the correct answer, as the pregnant woman does not increase her dietary intake significantly. The pregnant woman needs to consume adequate calories and nutrients to support the fetal growth and development, but not excessively. The recommended weight gain during pregnancy depends on the pre-pregnancy BMI of the woman, but generally ranges from 11 to 16 kg. The recommended calorie intake during pregnancy is about 300 kcal more than the pre-pregnancy intake, which is equivalent to one extra snack per day.