Maternal Child Nursing 5th Edition by McKinney- ISBN- 978-0323401708 TEST BANK Chapter 26: Concurrent Disorders during Pregnancy Verified 2024 Practice
... [Show More] Questions and 100% Correct Answers with Explanations for Exam Preparation, Graded A+ Preconception counseling is critical to the outcome of diabetic pregnancies because poor glycemic control before and during early pregnancy is associated with a. frequent episodes of maternal hypoglycemia. b. congenital anomalies in the fetus. c. polyhydramnios. d. hyperemesis gravid arum. ANS: B Preconception counseling is particularly important because strict metabolic control before conception and in the early weeks of gestation is instrumental in decreasing the risks of congenital anomalies. Frequent episodes of maternal hypoglycemia may occur during the first trimester (not before conception) as a result of hormone changes and the effects on insulin production and usage. Hydramnios occurs about 10 times more often in diabetic pregnancies than in nondiabetic pregnancies. Typically, it is seen in the third trimester of pregnancy. Hyperemesis gravid arum may exacerbate hypoglycemic events as the decreased food intake by the mother and glucose transfer to the fetus contribute to hypoglycemia. PTS: 1 DIF: Cognitive Level: Knowledge/Remembering REF: p. 550 OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity 2. In assessing the knowledge of a pregestational woman with type 1 diabetes concerning changing insulin needs during pregnancy, the nurse recognizes that further teaching is warranted when the patient states a. “I will need to increase my insulin dosage during the first 3 months of pregnancy.” b. “Insulin dosage will likely need to be increased during the second and third trimesters.” c. “Episodes of hypoglycemia are more likely to occur during the first 3 months.” d. “Insulin needs should return to normal within 7 to 10 days after birth if I am bottle feeding.” ANS: A Insulin needs are reduced in the first trimester due to increased insulin production by the pancreas and increased peripheral sensitivity to insulin. Also the woman may be experiencing nausea, vomiting, and anorexia that would decrease her insulin needs. The other statements show good understanding of this topic. PTS: 1 DIF: Cognitive Level: Evaluation/Evaluating REF: p. 553 OBJ: Nursing Process: Evaluation MSC: Client Needs: Physiologic Integrity [Show Less]