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 C
Explanation
The correct answer is choice C. Auscultate the fetal heart sounds.This is because spontaneous rupture of membranes (SROM) may be associated with fetal distress or cord prolapse, and the nurse should assess the fetal well-being as soon as possible.Fetal heart sounds can indicate the presence of fetal bradycardia, tachycardia, or decelerations, which may require immediate intervention.
Choice A is wrong because checking the specific gravity of the amniotic fluid is not a priority action after SROM.The specific gravity can help differentiate amniotic fluid from urine, but it is not as reliable as other methods such as nitrazine paper test or visual inspection.
Choice B is wrong because providing dry linens for the patient is a comfort measure, but not a priority action after SROM.The nurse should first ensure the safety of the fetus and the mother before attending to their comfort needs.
Choice D is wrong because notifying the health care provider is an important action after SROM, but not the first one.The nurse should gather relevant data such as fetal heart rate, maternal vital signs, and characteristics of the fluid before contacting the provider.
Correct Answer is C
Explanation
This is because the first priority for a pregnant woman with acute abdominal pain is to assess the fetal well-being and rule out any obstetric complications such as placental abruption, uterine rupture, or preterm labor.Fetal heart tones can indicate the presence and viability of the fetus and alert the nurse to any signs of fetal distress or hypoxia.
Choice A: Obtain a full history is wrong because it is not the most urgent action.
A full history can provide valuable information about the possible causes of abdominal pain, but it should not delay the assessment of fetal status and maternal vital signs.
Choice B: Examine the cervix for dilation is wrong because it can be harmful in some cases.A digital cervical examination should be avoided until placenta previa is ruled out by ultrasound, as it can cause bleeding and worsen the condition.
Moreover, cervical dilation alone does not indicate the cause or severity of abdominal pain.
Choice D: Palpate for uterine contraction frequency is wrong because it is not the most reliable method to assess labor.Uterine contractions can be measured by external tocodynamometry or internal intrauterine pressure catheter, which can provide more accurate and objective data than manual palpation.
Furthermore, uterine contractions do not necessarily indicate labor, as they can also be caused by other conditions such as dehydration, infection, or irritable uterus.
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