A woman who has type 2 diabetes mellitus is now pregnant.
She wants to know whether to take her oral antidiabetic medication.
What instructions will she receive?
She should continue the antidiabetic medication at the same dosage.
The antidiabetic medication dosage will be increased gradually throughout her pregnancy.
She will be switched to insulin therapy while she is pregnant.
She will not receive any antidiabetic medication while pregnant and will need to monitor her dietary intake closely.
The Correct Answer is C
Choice A rationale
Continuing the oral antidiabetic medication at the same dosage is incorrect. Most oral antidiabetic medications are classified as teratogenic or potentially teratogenic, meaning they can cause harm to the developing fetus. Their use is not recommended during pregnancy due to the risk of congenital anomalies and other complications. Therefore, the medication should be discontinued immediately.
Choice B rationale
Increasing the dosage of oral antidiabetic medication is incorrect. As discussed, oral antidiabetic agents are generally contraindicated in pregnancy due to their potential teratogenic effects on the fetus. Increasing the dose would exacerbate this risk. The standard of care for managing diabetes during pregnancy involves discontinuing these medications and initiating a safer alternative.
Choice C rationale
The correct instruction is that she will be switched to insulin therapy while pregnant. Insulin is the preferred treatment for managing diabetes during pregnancy because it does not cross the placental barrier and thus does not pose a risk to the fetus. It is a safe and effective way to achieve tight glycemic control, which is essential for a healthy pregnancy outcome and to prevent complications for both mother and baby.
Choice D rationale
Not receiving any medication while pregnant is incorrect. Poorly controlled diabetes during pregnancy significantly increases the risk of complications such as preeclampsia, macrosomia, and birth defects. Therefore, relying on diet and exercise alone is generally not sufficient to maintain stable blood glucose levels. Medical intervention, specifically insulin therapy, is necessary to ensure optimal maternal and fetal health.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Insulin glulisine is a rapid-acting insulin. Its onset of action is approximately 10 to 15 minutes, with a peak effect in about 30 to 90 minutes. It is typically administered immediately before or after a meal to manage postprandial glucose excursions. Rapid-acting insulins are used to mimic the natural insulin response to food intake.
Choice B rationale
Insulin isophane suspension (NPH) is an intermediate-acting insulin. It has a slower onset and longer duration of action compared to rapid- or short-acting insulins. Its onset is approximately 1 to 2 hours, with a peak effect in 4 to 12 hours. It is used to provide basal insulin coverage between meals and overnight.
Choice C rationale
Insulin detemir is a long-acting insulin. Its onset of action is gradual, typically starting 1 to 2 hours after administration, and it provides a steady, peakless glucose-lowering effect that can last for up to 24 hours. This type of insulin is designed to provide a continuous, basal level of insulin throughout the day or night.
Choice D rationale
Regular insulin is a short-acting insulin. It has an onset of action of 30 to 60 minutes, a peak effect in 2 to 4 hours, and a duration of 5 to 8 hours. It is used to cover meals and is the only insulin that can be administered intravenously in clinical settings for rapid glucose control.
Correct Answer is ["B","C"]
Explanation
Choice A rationale
While adequate fluid intake is important for overall health, it does not directly counteract the sedative or unsteady side effects of an anxiolytic medication. Increasing fluid intake will not improve drowsiness or unsteadiness caused by central nervous system depression, and it is not a standard or effective nursing intervention for these specific adverse effects.
Choice B rationale
Anxiolytics, particularly benzodiazepines, are central nervous system depressants that cause drowsiness and impair coordination and judgment. Due to the sedative effects and potential for unsteadiness and ataxia, it is crucial to advise patients to avoid activities that require alertness and precise motor skills, such as driving or operating heavy machinery, to prevent accidents.
Choice C rationale
Alcohol and anxiolytics are both central nervous system depressants. Taking them together has a synergistic effect, meaning their combined depressive effects are greater than the sum of their individual effects. This can significantly increase the risk of severe drowsiness, respiratory depression, and even coma or death. Patients must be warned to avoid alcohol completely.
Choice D rationale
Abruptly discontinuing an anxiolytic, especially a benzodiazepine, can lead to severe withdrawal symptoms, including rebound anxiety, insomnia, tremors, and even seizures. The medication should not be stopped immediately by the patient without consulting a healthcare provider. The dose should be tapered slowly under medical supervision to prevent these dangerous effects.
Choice E rationale
While light exercise can be beneficial for mood and anxiety, it is not a primary or safe recommendation for a patient experiencing drowsiness and unsteadiness due to anxiolytic medication. Engaging in physical activity while feeling unsteady could increase the risk of falls and injury. The priority is to ensure the patient's safety by avoiding risky activities.
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