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 B
Explanation
Choice A rationale
Preparing the abdominal and perineal areas is not the priority nursing action for a client who has a large amount of painless, bright red vaginal bleeding. This may indicate placenta previa, a condition where the placenta covers the cervical opening, which can cause life-threatening hemorrhage for both the mother and the fetus. The priority is to stabilize the client's hemodynamic status and prevent hypovolemic shock.
Choice B rationale
Initiating IV access is the priority nursing action for a client who has a large amount of painless, bright red vaginal bleeding. This allows the nurse to administer fluids and blood products as needed to maintain the client's blood pressure and perfusion. It also provides a route for administering medications such as tocolytics, which can inhibit uterine contractions and reduce bleeding.
Choice C rationale
Inserting a Foley catheter is not the priority nursing action for a client who has a large amount of painless, bright red vaginal bleeding. This may increase the risk of infection and trauma to the lower urinary tract. It is also contraindicated in placenta previa, as it may dislodge the placenta and worsen the bleeding.
Choice D rationale
Administering oxygen via face mask is not the priority nursing action for a client who has a large amount of painless, bright red vaginal bleeding. This may be beneficial to improve the oxygenation of the mother and the fetus, but it does not address the underlying cause of the bleeding or the potential hypovolemia. Oxygen therapy should be initiated after securing IV access and fluid resuscitation.
Correct Answer is B
Explanation
Choice A rationale
This is incorrect because repaglinide is not recommended for the treatment of gestational diabetes mellitus. Repaglinide is an oral antidiabetic agent that stimulates the release of insulin from the pancreas. However, it has not been adequately studied in pregnant women and may cause hypoglycemia or fetal harm.
Choice B rationale
This is correct because insulin is the preferred medication for the treatment of gestational diabetes mellitus. Insulin is a hormone that lowers the blood glucose levels by facilitating its uptake by the cells. Insulin does not cross the placenta and does not affect the fetal development. Insulin can be administered by injection or infusion, depending on the type and severity of the diabetes.
Choice C rationale
This is incorrect because glipizide is not recommended for the treatment of gestational diabetes mellitus. Glipizide is an oral antidiabetic agent that stimulates the release of insulin from the pancreas. However, it may cross the placenta and cause hypoglycemia or fetal abnormalities.
Choice D rationale
This is incorrect because acarbose is not recommended for the treatment of gestational diabetes mellitus. Acarbose is an oral antidiabetic agent that inhibits the digestion and absorption of carbohydrates in the intestine. However, it may cause gastrointestinal side effects, such as bloating, diarrhea, or flatulence, and it has not been proven to be safe or effective in pregnant women.
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