A patient who is 26 weeks pregnant has gestational diabetes and is to begin insulin management.
When discussing the patient’s insulin needs, which information should the nurse include?

Insulin amount needs will remain stable during the third trimester.

Insulin amount needs will continue to increase throughout the second and third trimesters.

Insulin amount needs will decrease during the third trimester.

Insulin amount needs will remain stable for the rest of the second and during the third trimesters.

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. Insulin amount needs will continue to increase throughout the second and third trimesters. This is because gestational diabetes is a form of diabetes that develops during pregnancy, usually during the 2nd or 3rd trimester. It is caused by hormonal changes that interfere with the action of insulin, leading to high blood sugar levels. As the pregnancy progresses, the placenta produces more hormones that increase insulin resistance, so the mother needs more insulin to keep her blood sugar within normal range.

Choice A is wrong because insulin amount needs will not remain stable during the third trimester. They will increase as the placenta grows and produces more hormones that cause insulin resistance.

Choice C is wrong because insulin amount needs will not decrease during the third trimester. They will increase as the placenta grows and produces more hormones that cause insulin resistance.

Choice D is wrong because insulin amount needs will not remain stable for the rest of the second and during the third trimesters. They will increase as the pregnancy progresses and the placenta produces more hormones that increase insulin resistance.

Normal ranges for blood sugar during pregnancy are: fasting < 95 mg/dL, 1 hour after meal < 140 mg/dL, 2 hours after meal < 120 mg/dL.

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Correct Answer is A

Explanation

Choice A reason:
At 37 weeks, especially in gestational diabetes, fetal lungs may still be immature. Amniocentesis checks lung maturity to ensure the baby can breathe effectively if early delivery is needed due to fetal compromise.

Choice B reason:
Fetal renal function is not typically assessed through amniocentesis at term. Kidney function is monitored via ultrasound, not by analyzing amniotic fluid at 37 weeks.

Choice C reason:
Amniotic fluid glucose levels are not used to manage gestational diabetes. Maternal blood glucose is the standard for monitoring and treatment.

Choice D reason:
Congenital anomalies are usually detected earlier in pregnancy. By 37 weeks, the focus of amniocentesis is on delivery planning, not anomaly detection.

A. Once the client’s intravenous terbutaline is discontinued, she will be taught to self-administer the drug parenterally. B. The administration route of terbutaline will be changed from intravenous to oral. C. The client will remain in a private room without visitors until she has been without contractions for 48 hours. D. After 12 hours without contractions, the client will ambulate in the hallway.

Correct Answer is B

Explanation

The correct answer is choice B. The administration route of terbutaline will be changed from intravenous to oral.

This is because terbutaline is a medication that can be used to suppress preterm labor by relaxing the uterine smooth muscle.It can be given subcutaneously or intravenously for acute episodes of preterm labor, but it is not recommended for long-term use due to the risk of serious maternal and fetal adverse effects.Therefore, if the client’s condition stabilizes, the administration route of terbutaline will be changed from intravenous to oral, which has a lower bioavailability and less systemic effects.

Choice A is wrong because terbutaline is not usually self-administered parenterally by the client at home.It requires a trained health professional to give it as a shot under the skin or through a vein.

Choice C is wrong because the client does not need to remain in a private room without visitors until she has been without contractions for 48 hours.

This is an unnecessary restriction that may increase the client’s stress and anxiety.

The client should be encouraged to have social support and emotional comfort during this time.

Choice D is wrong because the client should not ambulate in the hallway after 12 hours without contractions.

This may stimulate uterine activity and cause a recurrence of preterm labor.

The client should follow the provider’s instructions on bed rest and activity limitations.

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A patient who is 26 weeks pregnant has gestational diabetes and is to begin insulin management. When discussing the patient’s insulin needs, which information should the nurse include?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has gestational diabetes and is scheduled for an amniocentesis at 37 weeks of gestation due to suspected fetal compromise. What is the nurse’s best response to the client’s question as to why the amniocentesis test is being done?

Correct Answer is A

Explanation

A client in preterm labor is managed with terbutaline. Which will a nurse need to consider in planning care for this client?

Correct Answer is B

Explanation

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A patient who is 26 weeks pregnant has gestational diabetes and is to begin insulin management.
When discussing the patient’s insulin needs, which information should the nurse include?