A patient with no prenatal care is admitted to the labor and delivery unit.She is placed on an external fetal monitor, and an intravenous infusion is begun.
A tentative diagnosis of abruptio placentae is made.Which finding would support this diagnosis?

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.

The correct answer is choice C. Arrange for her to meet the staff who will be caring for her during labor and delivery.This measure can help reduce the anxiety and fear of the unknown that a primigravida may have in the last month of pregnancy.Meeting the staff can also help establish rapport and trust, which are essential for a positive birth experience.

Choice A is wrong because an increase in fetal activity does not necessarily require an increase in the need to rest.

Fetal activity is normal and expected, and the mother should monitor it regularly.Resting may help with some discomforts of pregnancy, but it is not directly related to fetal activity.

Choice B is wrong because back labor is not likely for a primigravida with an uncomplicated pregnancy.

Back labor occurs when the fetus is in an occiput posterior position, which puts pressure on the mother’s spine and causes intense pain in the lower back.This position is more common in multiparous women than primigravidas.

Choice D is wrong because testing urine for glucose is not a routine measure for a primigravida with an uncomplicated pregnancy.

Urine glucose testing is done for women who have gestational diabetes or are at risk of developing it.It is not necessary for women who have normal blood glucose levels.