Diabetes in pregnancy puts the fetus at risk in several ways.
Nurses should be aware that:.
With good control of maternal glucose levels, sudden and unexplained stillbirth is no longer a major concern.
The most important cause of perinatal loss in diabetic pregnancy is congenital malformations.
Infants of mothers with diabetes have the same risks for respiratory distress syndrome because of careful monitoring.
At birth, the neonate of a diabetic mother is no longer at any greater risk.
The Correct Answer is B
Choice A rationale:
With good control of maternal glucose levels, sudden and unexplained stillbirth is no longer a major concern. While controlling maternal glucose levels is important in diabetic pregnancies, it does not eliminate all risks, including the risk of stillbirth. However, the most significant cause of perinatal loss in diabetic pregnancies is congenital malformations. Poorly controlled diabetes during pregnancy can lead to structural abnormalities in the fetus, increasing the risk of perinatal loss.
Choice B rationale:
The most important cause of perinatal loss in diabetic pregnancy is congenital malformations. This is the correct answer. Poorly controlled diabetes increases the risk of congenital malformations in the fetus, making it a significant concern in diabetic pregnancies. Proper management of diabetes and prenatal care are essential to reduce this risk.
Choice C rationale:
Infants of mothers with diabetes have the same risks for respiratory distress syndrome because of careful monitoring. Infants of mothers with diabetes are at an increased risk of respiratory distress syndrome due to delayed lung maturation. Careful monitoring is essential, but it does not eliminate this risk. Proper management and timely interventions are necessary to minimize the impact of respiratory distress syndrome in these infants.
Choice D rationale:
At birth, the neonate of a diabetic mother is no longer at any greater risk. Infants of diabetic mothers are at increased risk for various complications, both during and after birth. These risks include hypoglycemia, respiratory distress syndrome, and hypocalcemia, among others. Close monitoring and appropriate interventions are required to ensure the well-being of the newborn.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Telling the patient that she should have felt the baby move by now might cause unnecessary anxiety if she hasn't experienced fetal movement yet. Fetal movement can vary, and some women might not feel it until later in their pregnancy. This statement does not provide accurate and reassuring information.
Choice B rationale:
Around 14 to 25 weeks of gestation, most women begin to feel fluttering sensations, which are the early movements of the baby. By stating that the patient should start feeling these sensations within the next month or so, the nurse provides an accurate and reassuring response based on the typical timeline for fetal movement.
Choice C rationale:
This statement is incorrect. While the baby is moving, it might not be perceivable to the mother due to various factors such as the position of the placenta or the baby's own activity patterns. Simply stating that the baby is moving does not address the patient's concern about feeling the movements.
Choice D rationale:
Some babies are indeed quiet, and their movements might not be as noticeable to the mother. However, this statement does not provide a specific timeframe or address the patient's immediate concern about when she will start feeling the baby move. It is essential to provide a more informative and reassuring response.
Correct Answer is A
Explanation
Choice A rationale:
The medication, Methylergonovine 0.2mg IM, is contraindicated due to the client's blood pressure. The patient's blood pressure reading is 155/95 mmHg, which indicates hypertension (high blood pressure). Methylergonovine is a medication used to manage postpartum hemorrhage by causing uterine contractions and reducing bleeding. However, it is contraindicated in patients with hypertension because it can significantly raise blood pressure, leading to complications such as stroke, heart attack, or hypertensive crisis. Administering this medication to a patient with high blood pressure can worsen their condition and pose serious risks.
Choice B rationale:
The multigravity (G-5) of the client (having had 5 pregnancies) is not a contraindication for Methylergonovine. The number of pregnancies a patient has had does not impact the contraindication criteria for this medication.
Choice C rationale:
The client's drug allergy to penicillin is not a contraindication for Methylergonovine. Allergies to specific medications do not affect the use of Methylergonovine for postpartum hemorrhage.
Choice D rationale:
The client's heart rate, which is not provided in the medical chart, does not directly contraindicate Methylergonovine. However, hypertension (elevated blood pressure) is the primary concern in this scenario, making choice A the correct answer.
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