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Exercises
Answers to case studies & questions are found in the Answer Key. Answers to the interactive elements are located within the element.
Case Study: Maternal Diabetes in Pregnancy[1]
Situation/Background
Mrs. Taylor, a 32-year-old woman, is 24 weeks pregnant with her second child. She has a history of type 2 diabetes mellitus, which was diagnosed five years ago. At her prenatal visit, her fasting blood glucose is 140 mg/dL, and her hemoglobin A1c is 7.8%. She reports feeling fatigued, experiencing frequent urination, and noticing occasional blurred vision. Her current medications include metformin, but she admits to occasional missed doses. Her diet consists of frequent fast-food meals due to her busy work schedule.
The health care provider orders dietary counseling, blood glucose monitoring, and potential insulin therapy.
Critical Thinking Questions
- Which of the following fetal complications is Mrs. Taylor’s baby at risk for due to her uncontrolled diabetes?
- a. Neural tube defects
- b. Macrosomia
- c. Placental abruption
- d. Oligohydramnios
- Mrs. Taylor asks why her provider is recommending insulin therapy when she is already on metformin. What is the best response by the nurse?
- a. “Insulin is necessary because oral medications are not safe during pregnancy.”
- b. “Insulin will help control your blood sugar more effectively because your levels are still high.”
- c. “Metformin should be discontinued immediately, as it can harm your baby.”
- d. “Your baby needs extra glucose to grow, so insulin is not needed unless your blood sugar drops too low.”
- Which nursing intervention is the priority when educating Mrs. Taylor about managing her diabetes during pregnancy?
- a. Encouraging an exercise routine with at least 60 minutes of activity per day
- b. Advising her to avoid all carbohydrate intake to lower her blood sugar
- c. Teaching her how to monitor her blood glucose levels regularly and adjusting her diet accordingly
- d. Recommending that she increase her caloric intake to prevent hypoglycemia
- Mrs. Taylor’s blood glucose levels remain elevated despite dietary changes and insulin therapy. For what potential complication should the nurse assess?
- a. Preeclampsia
- b. Hyperemesis gravidarum
- c. Anemia
- d. Rh incompatibility
- During labor, Mrs. Taylor’s blood glucose is closely monitored. Why is this necessary?
- a. To ensure the baby does not experience hypoglycemia after birth
- b. To prevent an emergency C-section
- c. To decrease the risk of postpartum hemorrhage
- d. To avoid the need for pain medication during delivery
- After delivery, Mrs. Taylor asks about her long-term diabetes management. What is the best nursing advice?
- a. “Because pregnancy is over, your diabetes will return to normal without medication.”
- b. “You may need less insulin now, but you should continue monitoring your blood sugar closely.”
- c. “You will likely develop type 1 diabetes now that you’ve been on insulin.”
- d. “Breastfeeding is not recommended because of your diabetes.”
An interactive H5P element has been excluded from this version of the text. You can view it online here:
https://wtcs.pressbooks.pub/healthpromo/?p=6842#h5p-42
An interactive H5P element has been excluded from this version of the text. You can view it online here:
https://wtcs.pressbooks.pub/healthpromo/?p=6842#h5p-43
An interactive H5P element has been excluded from this version of the text. You can view it online here:
https://wtcs.pressbooks.pub/healthpromo/?p=6842#h5p-44
Test your knowledge using this NCLEX Next Generation-style question. You may reset and resubmit your answers to this question an unlimited number of times.[5]
- “Maternal Diabetes in Pregnancy Case Study” by OpenRN is licensed under CC BY-NC 4.0 ↵
- “HP High-Risk Newborn Care Glossary Cards" by OpenRN is licensed under CC BY-NC 4.0 ↵
- “HP High-Risk Newborn Care Pre-term Question Set” by OpenRN is licensed under CC BY-NC 4.0 ↵
- “HP High-Risk Newborn Care Post-term/Misc Question Set” by OpenRN is licensed under CC BY-NC 4.0 ↵
- “HP Chapter 20 Question 1” by Tami Davis for OpenRN is licensed under CC BY-NC 4.0 ↵