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
Explanation
Choice A rationale
Bradycardia (heart rate 56 beats/minute) is common postpartum due to increased stroke volume and reduced heart rate, reflecting physiological adaptation after delivery.
Choice B rationale
Saturating two perineal pads per hour is excessive and could indicate postpartum hemorrhage, requiring immediate evaluation and intervention.
Choice C rationale
A soft, spongy fundus indicates uterine atony, a serious condition requiring urgent intervention to prevent postpartum hemorrhage.
Choice D rationale
Unilateral lower leg pain could indicate deep vein thrombosis (DVT), a significant postpartum complication needing immediate medical attention.
Correct Answer is A
Explanation
Choice A rationale
SROM for 36 hours before delivery significantly increases the risk of postpartum endometritis due to prolonged exposure of the uterine cavity to potential pathogens. Prompt antibiotic therapy may be required to prevent infection.
Choice B rationale
Labor lasting for 24 hours can contribute to maternal fatigue and increased risk of complications, but it is not the primary factor for postpartum endometritis. The duration of rupture of membranes is more critical in this context.
Choice C rationale
A third-degree perineal laceration poses a risk for infection at the wound site but is not the leading cause of postpartum endometritis. The primary concern remains the extended duration of ruptured membranes.
Choice D rationale
Epidural anesthesia is not directly associated with an increased risk of postpartum endometritis. Its primary effects are related to pain management and potential impacts on labor progression, not infection risk.
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