A woman who is 26 weeks pregnant has just found out that she has gestational diabetes. Which of the following therapies will most likely be ordered first for this patient?

Oral hypoglycemic medications

Diet control and exercise

Inhaled insulin

Regular insulin injections

Answer and Explanation

The Correct Answer is B

A. Oral hypoglycemic medications. While some oral hypoglycemic agents, such as metformin or glyburide, are used in gestational diabetes, the first-line treatment is always dietary modification and exercise. Medications are only introduced if blood glucose levels remain uncontrolled with lifestyle changes.

B. Diet control and exercise. The initial treatment for gestational diabetes focuses on controlling blood glucose through dietary adjustments, portion control, and regular physical activity. If lifestyle modifications fail to maintain glucose levels within the target range, insulin or oral medications may be introduced.

C. Inhaled insulin. Inhaled insulin is not commonly used in pregnancy because its safety and efficacy for gestational diabetes have not been well established. Insulin therapy, if needed, is typically administered via subcutaneous injection rather than inhalation.

D. Regular insulin injections. Insulin therapy is considered if diet and exercise alone fail to control blood glucose levels. However, it is not the first-line treatment, as many women can successfully manage gestational diabetes without requiring insulin therapy.

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Correct Answer is A

Explanation

A. Contraction frequency of 1 minute. Misoprostol (Cytotec) is used for cervical ripening, but excessive uterine contractions (tachysystole), defined as more than five contractions in 10 minutes, can lead to fetal distress and uterine rupture. If contractions are occurring every minute, this indicates hyperstimulation, requiring immediate discontinuation of the medication and possible intervention with tocolytics to relax the uterus.

B. Cervix is 50% effaced. Cervical effacement is a normal part of labor progression and does not indicate a need to stop Cytotec treatment. Misoprostol is intended to help soften and ripen the cervix, and 50% effacement suggests the cervix is responding appropriately.

C. Maternal respiratory rate of 24. A respiratory rate of 24 breaths per minute is within the upper normal range for pregnancy due to increased metabolic demands. It does not indicate an adverse reaction to misoprostol or warrant discontinuation of treatment.

D. Fetal heart baseline of 150. A fetal heart rate of 150 beats per minute is within the normal range of 110-160 bpm and does not indicate fetal distress. There is no reason to stop Cytotec based on this finding.

A. Correct coagulation failure by giving platelets B. Provide emotional support to the woman and her family. C. Maintain cardiac output and entice intakes & output. D. Administer oxygen by tight face mask B-10L/min.

Correct Answer is D

Explanation

A. Correct coagulation failure by giving platelets. Anaphylactoid syndrome of pregnancy (amniotic fluid embolism) can cause disseminated intravascular coagulation (DIC), but correcting coagulation abnormalities is not the immediate priority. The first intervention should focus on oxygenation and stabilizing the cardiovascular system.

B. Provide emotional support to the woman and her family. While emotional support is important, this is not the priority in a life-threatening emergency. The focus should be on immediate resuscitation efforts to prevent maternal and fetal death.

C. Maintain cardiac output and assess intake & output. Maintaining cardiac output is critical, but this is secondary to oxygenation. The initial response should be administering high-flow oxygen to improve maternal and fetal oxygenation before managing hemodynamic stability.

D. Administer oxygen by tight face mask 8-10L/min. Amniotic fluid embolism causes sudden respiratory distress, hypoxia, and cardiovascular collapse. Immediate high-flow oxygen delivery is the first and most critical intervention to improve oxygenation, support cardiac function, and prevent further complications.

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A woman who is 26 weeks pregnant has just found out that she has gestational diabetes. Which of the following therapies will most likely be ordered first for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client has been admitted to the labor and delivery suite for induction of labor for post-term pregnancy. Misoprostol (Cytotec) has been inserted. Which of the following findings would warrant stopping the Cytotec treatment?

Correct Answer is A

Explanation

If the nurse suspects a patient has experienced anaphylactoid syndrome of pregnancy (amniotic fluid embolus), which of the following is the priority nursing intervention?

Correct Answer is D

Explanation

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