In terms of the incidence and classification of diabetes, maternity nurses should know that:
Type 1 diabetes is most common
Type 2 diabetes often goes undiagnosed
Type 1 diabetes may become type 2 during pregnancy
Gestational diabetes mellitus (GDM) means that the woman will be receiving insulin treatment until 6 weeks after birth
The Correct Answer is B
Choice A rationale
Type 1 diabetes is not the most common type of diabetes. Type 1 diabetes is a condition where the pancreas produces little or no insulin, which is a hormone that regulates the blood glucose level. Type 1 diabetes usually develops in childhood or adolescence and requires lifelong insulin therapy. Type 1 diabetes accounts for about 5% to 10% of all cases of diabetes.
Choice B rationale
Type 2 diabetes often goes undiagnosed. Type 2 diabetes is a condition where the body becomes resistant to the action of insulin or the pancreas produces insufficient insulin. Type 2 diabetes usually develops in adulthood and is associated with obesity, physical inactivity, and family history. Type 2 diabetes can be managed with diet, exercise, oral medications, or insulin. Type 2 diabetes accounts for about 90% to 95% of all cases of diabetes. However, many people with type 2 diabetes do not have any symptoms or are unaware of their condition, which can lead to delayed diagnosis and complications.
Choice C rationale
Type 1 diabetes cannot become type 2 during pregnancy. Type 1 and type 2 diabetes are different conditions with different causes and treatments. Type 1 diabetes is an autoimmune disorder that destroys the insulin-producing cells in the pancreas, while type 2 diabetes is a metabolic disorder that impairs the insulin sensitivity or secretion. Type 1 diabetes cannot be reversed or prevented, while type 2 diabetes can be prevented or delayed with lifestyle changes.
Choice D rationale
Gestational diabetes mellitus (GDM) does not mean that the woman will be receiving insulin treatment until 6 weeks after birth. GDM is a condition where the blood glucose level becomes elevated during pregnancy, usually after 24 weeks of gestation. GDM can cause complications for the mother and the fetus, such as preeclampsia, macrosomia, and neonatal hypoglycemia. GDM can be managed with diet, exercise, oral medications, or insulin. GDM usually resolves after delivery, but the woman should be tested for diabetes 6 to 12 weeks postpartum, as she has a higher risk of developing type 2 diabetes later in life.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Administering oxygen via face mask is a secondary intervention for late decelerations, which indicate fetal hypoxia. Oxygen may improve the fetal oxygenation, but it does not address the underlying cause of the late decelerations, which is uteroplacental insufficiency.
Choice B rationale
Increasing the infusion rate of the IV fluid is another secondary intervention for late decelerations. IV fluid may increase the maternal blood volume and cardiac output, but it does not improve the placental blood flow, which is the main problem in late decelerations.
Choice C rationale
Elevating the client's legs is not an appropriate intervention for late decelerations. Elevating the legs may reduce the venous return and lower the blood pressure, which can worsen the uteroplacental insufficiency and the fetal hypoxia.
Choice D rationale
Positioning the client on her side is the priority nursing action for late decelerations. This position reduces the pressure of the gravid uterus on the inferior vena cava and the aorta, which improves the maternal and fetal circulation and oxygenation.
Correct Answer is A
Explanation
Choice A rationale
This is correct because hyperinsulinemia is the most likely cause of the respiratory distress in the newborn. Hyperinsulinemia is a condition where the newborn has high levels of insulin in the blood, due to the exposure to the mother's high blood glucose levels during pregnancy. Insulin causes the breakdown of glucose and the production of carbon dioxide, which increases the respiratory demand and leads to respiratory distress syndrome.
Choice B rationale
This is incorrect because increased deposits of fat in the chest and shoulder area are not the most likely cause of the respiratory distress in the newborn. Increased deposits of fat are a characteristic of macrosomia, which is a condition where the newborn has a birth weight of more than 4,000 g. Macrosomia can cause difficulty in delivery and increase the risk of birth injuries, but it does not directly affect the respiratory function of the newborn.
Choice C rationale
This is incorrect because brachial plexus injury is not the most likely cause of the respiratory distress in the newborn. Brachial plexus injury is a condition where the nerves that supply the arm and hand are damaged during delivery, due to excessive traction or compression. Brachial plexus injury can cause weakness, numbness, or paralysis of the affected arm, but it does not affect the respiratory function of the newborn.
Choice D rationale
This is incorrect because increased blood viscosity is not the most likely cause of the respiratory distress in the newborn. Increased blood viscosity is a condition where the blood is thicker and flows more slowly, due to the high concentration of red blood cells. Increased blood viscosity can increase the risk of thrombosis and polycythemia, but it does not directly affect the respiratory function of the newborn.
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