A patient with diabetes who is in the second trimester of ...

[Pineappleeh]

A patient with diabetes who is in the second trimester of pregnancy notes that the usual dose of insulin to maintain blood glucose levels has been increasing over the last few weeks.
 
  What should the nurse explain to the patient about insulin during pregnancy? A) The fetus is using insulin to maintain blood glucose level in utero.
  B) Insulin resistance develops because of placenta and other hormones.
  C) An increase in circulating blood volume during pregnancy deactivates insulin.
  D) The change in diet causes an increased need for insulin to maintain blood glucose levels.

Question 2

The nurse determines that a pregnant patient is at risk for developing a deep vein thrombosis. What should the nurse instruct the patient to reduce the risk of this potential complication? (Select all that apply.)
 
  A) Avoid foods high in calcium.
  B) Take a baby aspirin every day.
  C) Avoid standing in one position.
  D) Do not cross the legs at the knee.
  E) Do not wear knee-high stockings.

[Kingjoffery]

Answer to Question 1

B
Feedback:
Patients with diabetes, who become pregnant, develop insulin resistance as the pregnancy progresses, or insulin does not seem as effective during pregnancy. This phenomenon is believed to be caused by the presence of the hormone human placental lactogen and high levels of cortisol, estrogen, progesterone, and catecholamines. The increased need for insulin is not because of the fetus using insulin to maintain blood glucose level in utero. The patient's increased circulating blood volume is not deactivating insulin. The patient's change in diet might necessitate an adjustment in insulin dosage, but this would vary according to blood glucose level.

Answer to Question 2

C, D, E
Feedback:
The risk of thrombus formation can be reduced through measures such as avoiding the use of constrictive knee-high stockings, not sitting with legs crossed at the knee, and avoiding standing in one position for a long period. Calcium restriction does not reduce the risk of thrombus formation and could potentially harm the developing fetus. The nurse cannot prescribe medication, and the patient should not take any medication without direction from the health care provider.