chapter 15-pregnancy at risk-preexisting conditions Flashcards
In assessing the knowledge of a pregestational woman with type 1 diabetes about changing insulin needs during pregnancy, which information is accurate?
a. Insulin dosage during the first 3 months of pregnancy needs to be increased.
b. Insulin dosage will likely need to be decreased during the second and third trimesters.
c. Episodes of hypoglycemia are more likely to occur during the last 3 months.
d. Insulin needs should return to normal within 7 to 10 days after birth if bottle-feeding.
D
Which is attributable to poor glycemic control before and during early pregnancy?
a. Frequent episodes of maternal hypoglycemia
b. Congenital anomalies in the fetus
c. Polyhydramnios
d. Hyperemesis gravidarum
B
In planning for the care of a 30-year-old woman with pregestational diabetes, what does the nurse recognize as the most important factor affecting pregnancy outcome?
a. Mother’s age
b. Number of years since diabetes was diagnosed
c. Amount of insulin required prenatally
d. Degree of glycemic control during pregnancy
D
What normal fasting glucose level should the nurse recommend for a woman with pregestational diabetes?
a. 2.5–3.5 mmol/L
b. 3.8–5.2 mmol/L
c. 5.5–7.7 mmol/L
d. 5.0–6.6 mmol/L
B
What is the greatest risk for a fetus of a pregnant woman who has gestational diabetes mellitus (GDM)?
a. Macrosomia
b. Congenital anomalies of the central nervous system
c. Postterm birth
d. Low birth weight
A
Which should the nurse know regarding drug testing during pregnancy in Canada?
a. It is required at the first prenatal visit.
b. Only those drugs disclosed by the woman are tested for.
c. There is no legal requirement to test the mother or the newborn child.
d. Testing is required before labour and delivery.
C
Which should the nurse know in terms of the incidence and classification of diabetes?
a. Type 1 diabetes is most common.
b. Type 2 diabetes often goes undiagnosed.
c. Gestational diabetes mellitus (GDM) means that the woman will be receiving insulin treatment until 6 weeks after birth.
d. Type 1 diabetes may become type 2 during pregnancy.
B
Metabolic changes throughout pregnancy that affect glucose and insulin in the mother and the fetus are complicated but important to understand. Which is important for the nurse to know?
a. Insulin crosses the placenta to the fetus only in the first trimester, after which the fetus secretes its own.
b. Women with insulin-dependent diabetes are prone to hyperglycemia during the first trimester because they are consuming more sugar.
c. During the second and third trimesters pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus.
d. Maternal insulin requirements steadily decline during pregnancy.
C
What should the nurse be aware of with regard to maternal diabetes affecting the mother and fetus?
a. Diabetic ketoacidosis (DKA) can lead to fetal death at any time during pregnancy.
b. Hydramnios occurs less often in diabetic pregnancies.
c. Infections occur about as often and are considered about as serious in diabetic and nondiabetic pregnancies.
d. Even mild-to-moderate hypoglycemic episodes can have significant effects on fetal well-being.
A
What should the nurse be aware of in relation to diabetes in pregnancy?
a. With good control of maternal glucose levels, sudden and unexplained stillbirth is no longer a major concern.
b. The most important cause of perinatal loss in diabetic pregnancy is congenital malformations.
c. Infants of mothers with diabetes have the same risks for central nervous system (CNS) defects as infants of mothers that do not have diabetes.
d. At birth the newborn of a diabetic mother is no longer at any risk.
B
The nurse providing care for a woman with gestational diabetes understands which about a laboratory test for glycosylated hemoglobin Alc?
a. The test is now done for all pregnant women, not just those with or likely to have diabetes.
b. The test is a snapshot of glucose control at the moment.
c. The test is completed to evaluate recent glycemic control.
d. The test is done on the patient’s urine, not her blood.
C
A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels. She shows the nurse her readings for the past few days. Which reading should the nurse tell her is not within the normal limits for blood glucose levels?
a. 3.2 mmol/L
b. 3.8 mmol/L
c. 4.2 mmol/L
d. 4.8 mmol/L
A
Which factor increases the risk of mother-to-child perinatal HIV transmission?
a. Treatment with antiretroviral
b. Presence of chorioamnionitis
c. Bottle-feeding after delivery
d. Maternal plasma viral level less than 1000 copies per mL
B
Which statement is accurate in providing perinatal care for women who use substances?
a. A decision to stop using substances must be made by the family.
b. Harm reduction practices are not effective with pregnant women.
c. Effects of perinatal substance use in pregnancy and postpartum must be reviewed.
d. Use of community resources for women to eliminate a social bias for perinatal care must be avoided.
C
The nurse must be alert for which signs and symptoms of cardiac decompensation when caring for a pregnant woman with cardiac problems?
a. A regular heart rate and hypertension
b. An increased urinary output, tachycardia, and slow respirations
c. Shortness of breath, bradycardia, and hypertension
d. Frequent cough; crackles; and an irregular, weak pulse
D
