Why is glucose metabolism profoundly affected during pregnancy?

The pregnant woman uses glucose at a more rapid rate than the nonpregnant woman.

Placental hormones are antagonistic to insulin, thus resulting in insulin resistance.

Pancreatic function in the islets of Langerhans is affected by pregnancy.

The pregnant woman increases her dietary intake significantly.

Answer and Explanation

The Correct Answer is B

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.

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Correct Answer is D

Explanation

Choice A reason: Quickening is the first perception of fetal movement by the pregnant woman, usually felt between 16 and 20 weeks of gestation. However, quickening can also be confused with gas or peristalsis, which are normal digestive processes that cause sensations in the abdomen.

Choice B reason: Chadwick sign is a bluish discoloration of the cervix, vagina, and vulva due to increased blood flow during pregnancy. It can be observed by the examiner as early as 6 weeks of gestation. However, Chadwick sign can also be caused by pelvic congestion, which is a chronic condition of enlarged and dilated veins in the pelvis².

Choice C reason: Amenorrhea is the absence of menstrual periods, which is one of the most common signs of pregnancy. However, amenorrhea can also be caused by stress, endocrine problems, or other factors that affect the hormonal balance and ovulation.

Choice D reason: Goodell sign is the softening of the cervix due to increased vascularity and edema during pregnancy. It can be palpated by the examiner around 6 to 8 weeks of gestation. Goodell sign is not associated with any other condition besides pregnancy, unlike cervical polyps, which are benign growths of the cervical tissue that can cause bleeding or discharge.

A. Have the patient stand up and retake her blood pressure. B. Have the patient lie supine for 5 minutes and recheck her blood pressure on both arms. C. Have the patient sit down and hold her arm in a dependent position. D. Have the patient turn to her left side and recheck her blood pressure in 5 minutes.

Correct Answer is D

Explanation

Choice A reason: This is not a good intervention, as it may worsen the symptoms of faintness, dizziness, and agitation. Standing up can cause a sudden drop in blood pressure (orthostatic hypotension), which can reduce the blood flow to the brain and the fetus. This can cause lightheadedness, blurred vision, and loss of consciousness in the woman, as well as fetal distress or hypoxia.

Choice B reason: This is not a good intervention, as it may also worsen the symptoms of faintness, dizziness, and agitation. Lying supine can cause compression of the inferior vena cava (a large vein that returns blood to the heart) by the gravid uterus, which can reduce the cardiac output (the amount of blood pumped by the heart) and the blood pressure. This can cause nausea, sweating, and visual disturbances in the woman, as well as fetal distress or hypoxia.

Choice C reason: This is not a good intervention, as it may not improve the symptoms of faintness, dizziness, and agitation. Sitting down and holding the arm in a dependent position can lower the blood pressure in the arm, but not in the rest of the body. This can cause inaccurate readings of the blood pressure and delay the detection of hypotension or hypertension. This can also cause discomfort and pain in the arm due to impaired circulation.

Choice D reason: This is the best intervention, as it can relieve the symptoms of faintness, dizziness, and agitation by improving the blood flow to the brain and the fetus. Turning to the left side can reduce the pressure of the uterus on the inferior vena cava and increase the cardiac output and the blood pressure. This can also optimize the placental perfusion (the blood flow to the placenta) and the fetal oxygenation.

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Why is glucose metabolism profoundly affected during pregnancy?

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Naxlex Comprehensive Predictor Exams

Which presumptive sign (felt by the woman) or probable sign (observed by the examiner) of pregnancy is not matched with another possible cause?

Correct Answer is D

Explanation

What is the best nursing intervention for a pregnant woman in her third trimester who complains of feeling faint, dizzy, and agitated while her vital signs are being assessed?

Correct Answer is D

Explanation

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