A nurse is caring for a 24-year-old pregnant woman in the prenatal clinic. She is gravida 2, para 1 (G2P1), and her mother has a history of type 2 diabetes mellitus.
Exhibits:
Which is likely causing this client's increased blood glucose at 28 weeks? Select all that apply.
Fetal health problems
Decreased cortisol
Increased insulin needs
Placental infection
Normal weight gain of pregnancy
Fetus with macrosomia
Correct Answer : C,E,F
Choice A rationale: Fetal health problems are not directly linked to maternal blood glucose levels. The fetus relies on maternal glucose, but fetal health issues do not cause maternal hyperglycemia.
Choice B rationale: Decreased cortisol is unlikely to cause increased blood glucose levels. Cortisol typically raises blood glucose by promoting gluconeogenesis and decreasing glucose uptake by cells.
Choice C rationale: Increased insulin needs during pregnancy are due to insulin resistance caused by placental hormones. This physiological change ensures adequate glucose supply to the fetus, leading to higher maternal blood glucose levels.
Choice D rationale: Placental infection can cause inflammation and other complications but is not a common cause of increased blood glucose levels. Infections typically present with fever and other systemic symptoms.
Choice E rationale: Normal weight gain during pregnancy can contribute to insulin resistance. Increased adipose tissue leads to higher levels of circulating free fatty acids, which impair insulin signaling and glucose uptake.
Choice F rationale: A fetus with macrosomia is often associated with maternal hyperglycemia. Excess glucose crosses the placenta, stimulating fetal insulin production and growth, leading to larger fetal size.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
Choice A rationale
Acidemia in the fetus can result from abnormal fetal heart rate (FHR) patterns. It is indicative of hypoxia and inadequate oxygenation, leading to anaerobic metabolism and accumulation of lactic acid in fetal tissues.
Choice B rationale
Hypoxia can occur due to abnormal FHR patterns. Hypoxia results from insufficient oxygen supply to the fetus, which can lead to metabolic acidosis, impaired organ function, and potential long-term developmental issues.
Choice C rationale
Hypoglycemia is not directly related to abnormal FHR patterns. It is primarily associated with metabolic disturbances such as inadequate glucose supply or insulin regulation in the neonate or fetus.
Choice D rationale
Meconium stool passage can result from fetal hypoxia due to abnormal FHR patterns. Hypoxia increases gastrointestinal peristalsis, leading to the release of meconium into the amniotic fluid, which poses a risk for aspiration.
Choice E rationale
Maternal hypotension can lead to abnormal FHR patterns. Hypotension reduces uteroplacental blood flow, leading to fetal hypoxia and compromised oxygen delivery to the fetus, which can result in fetal distress.
Correct Answer is A
Explanation
Choice A rationale
The postpartum period is characterized by leukocytosis, where WBC counts can rise to 30,000/mm³ due to physiological stress. A WBC count of 15,000/mm³ is within the expected range for this client.
Choice B rationale
Perineal hematomas are more likely to cause localized pain and swelling than systemic symptoms. The assessment of perineal area is important but not the first priority in this context.
Choice C rationale
Monitoring temperature, heart rate, and respirations is crucial to identify infection but checking the differential to confirm normal physiological response to postpartum is prioritized first.
Choice D rationale
Notifying the HCP for an elevated WBC count without additional signs of infection is premature. A WBC count of 15,000/mm³ alone is not indicative of an infection in postpartum clients.
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