What should the nurse tell a pregnant woman at 10 weeks of gestation who jogs 3 or 4 times per week and is concerned about the effect of exercise on the fetus?

Choice A reason: This is not the correct answer, as the pregnant woman does not use glucose at a more rapid rate than the nonpregnant woman. In fact, the pregnant woman has lower fasting glucose levels and higher postprandial glucose levels than the nonpregnant woman. This is because the pregnant woman adapts to the increased fetal demand for glucose by increasing her insulin secretion and decreasing her hepatic glucose production.

Choice B reason: This is the correct answer, as placental hormones are antagonistic to insulin, thus resulting in insulin resistance. Insulin resistance is a condition where the cells do not respond well to insulin and require more insulin to maintain normal glucose levels. Placental hormones, such as human placental lactogen, progesterone, and cortisol, increase the insulin resistance of the maternal tissues, especially in the second and third trimesters of pregnancy. This is to ensure that the fetus has enough glucose supply, as the placenta is not insulin resistant and can transport glucose to the fetus².

Choice C reason: This is not the correct answer, as pancreatic function in the islets of Langerhans is not affected by pregnancy. The islets of Langerhans are clusters of cells in the pancreas that produce hormones, such as insulin and glucagon, that regulate glucose metabolism. Pregnancy does not impair the function of the islets of Langerhans, but rather stimulates them to increase their size and number. This is to compensate for the increased insulin resistance and glucose demand of the pregnancy.

Choice D reason: This is not the correct answer, as the pregnant woman does not increase her dietary intake significantly. The pregnant woman needs to consume adequate calories and nutrients to support the fetal growth and development, but not excessively. The recommended weight gain during pregnancy depends on the pre-pregnancy BMI of the woman, but generally ranges from 11 to 16 kg. The recommended calorie intake during pregnancy is about 300 kcal more than the pre-pregnancy intake, which is equivalent to one extra snack per day.

Choice A reason: This is incorrect because oral antiviral therapy is not effective for PID, which is caused by bacterial infection. Antiviral therapy is used for viral infections, such as herpes or HIV.

Choice B reason: This is incorrect because antibiotics only until symptoms subside is not sufficient for PID, which can cause serious complications, such as infertility, ectopic pregnancy, or chronic pelvic pain. Antibiotics should be continued for the full course of treatment, usually 14 days, to ensure complete eradication of the infection.

Choice C reason: This is incorrect because frequent pelvic examination to monitor the progress of healing is not recommended for PID, which can cause inflammation and irritation of the pelvic organs. Pelvic examination should be avoided or minimized to prevent further trauma or spread of the infection.

Choice D reason: This is correct because bed rest in a semi-Fowler position is beneficial for PID, which can cause fluid accumulation and pressure in the pelvic cavity. Bed rest helps to reduce inflammation and pain, while semi-Fowler position helps to drain the fluid and prevent abscess formation.