A patient who is 26 weeks pregnant has gestational diabetes and is to begin insulin management.
When discussing the patient’s insulin needs, which information should the nurse include?
Insulin amount needs will remain stable during the third trimester.
Insulin amount needs will continue to increase throughout the second and third trimesters.
Insulin amount needs will decrease during the third trimester.
Insulin amount needs will remain stable for the rest of the second and during the third trimesters.
The Correct Answer is B
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is choice B.“The placenta was blocking the opening of the womb.”
This statement shows that the patient understands that placenta previa is a condition where the placenta covers or is near the internal os of the cervix, which prevents a safe vaginal delivery.The patient would need a cesarean delivery to avoid bleeding and complications.
Choice A is wrong because it describes placental abruption, not placenta previa.
Placental abruption is when the placenta separates from the uterine wall before delivery, which can cause severe bleeding and fetal distress.
Choice C is wrong because it describes a normal position of the placenta at the top of the womb.
This does not interfere with vaginal delivery and does not cause bleeding.
Choice D is wrong because it describes placenta increta or percreta, not placenta previa.
Placenta increta or percreta is when the placenta grows too deeply into or through the uterine wall, which can cause severe bleeding and damage to the uterus and other organs.
Correct Answer is D
Explanation
This is because epidural anesthesia can cause hypotension (low blood pressure) which can affect the placental blood flow and fetal oxygenation.
The nurse should monitor the patient’s blood pressure frequently and intervene if it drops below the baseline.
Choice A is wrong because assessing the patient’s urine for acetone is not relevant to the side effects of epidural anesthesia.Acetone in urine can indicate diabetic ketoacidosis, a complication of diabetes that occurs when the body breaks down fat for energy due to lack of insulin.
However, this is not related to epidural anesthesia.
Choice B is wrong because monitoring the patient’s deep tendon reflexes is not relevant to the side effects of epidural anesthesia.Deep tendon reflexes can be affected by magnesium sulfate, a medication used to prevent seizures in patients with preeclampsia (a condition characterized by high blood pressure and proteinuria in pregnancy).
However, this is not related to epidural anesthesia.
Choice C is wrong because assessing the patient’s pupillary accommodation is not relevant to the side effects of epidural anesthesia.
Pupillary accommodation is the ability of the eye to adjust its focus from distant to near objects.It can be impaired by drugs that affect the nervous system, such as opioids or anticholinergics.
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