A multiparous patient delivered her first child vaginally 2 years ...

[crobinson2013]

A multiparous patient delivered her first child vaginally 2 years ago, and delivered an infant by cesarean yesterday due to breech presentation. Which statement would the nurse expect the patient to make?
 
  1. I can't believe how much more tired I was with the first baby.
  2. I'm having significantly more pain this time than with my last birth.
  3. It is disappointing that I can't breastfeed because of the cesarean.
  4. Getting in and out of bed feels more comfortable than last time.

Question 2

A newly diagnosed insulin-dependent type 1 diabetic with good blood sugar control is at 20 weeks' gestation. She asks the nurse how her diabetes will affect her baby. What would the best explanation include?
 
  1. Your baby could be smaller than average at birth.
  2. Your baby will probably be larger than average at birth.
  3. As long as you control your blood sugar, your baby will not be affected at all.
  4. Your baby might have high blood sugar for several days.

[ricroger]

Answer to Question 1

2
Rationale 1: The mother is likely to feel more fatigue from the cesarean than from a vaginal birth.
Rationale 2: Recovery from cesarean birth recovery is longer, and involves more pain and fatigue than recovery from a vaginal birth due to the physiologic requirements of healing.
Rationale 3: Breastfeeding is not contraindicated by cesarean birth.
Rationale 4: Getting in and out of bed is more painful after cesarean birth than after vaginal birth.

Answer to Question 2

2
Explanation: 2. Characteristically, infants of mothers with diabetes are large for gestational age (LGA) as a result of high levels of fetal insulin production stimulated by the high levels of glucose crossing the placenta from the mother. Sustained fetal hyperinsulinism and hyperglycemia ultimately lead to excessive growth, called macrosomia, and deposition of fat.