Author Question: A client who has type 2 diabetes is pregnant with her second child. She was not diagnosed with ... (Read 39 times)

james · **on:** Jun 28, 2018

A client who has type 2 diabetes is pregnant with her second child. She was not diagnosed with diabetes until after her first pregnancy. Past obstetric history is unremarkablespontan eous vaginal birth of a male weighing 7 pounds, 15 ounces.

The client is now concerned over what will happen during this subsequent pregnancy as a result of her disease process. What impact could the disease process have on her upcoming birth?

a. Client will not be able to receive an epidural for pain management.
b. Client will not be able to have a vaginal birth.
c. A planned birth will be instituted by her health care provider.
d. It is likely that she will deliver a fetus who is small for gestational age (SGA).

Question 2

A client has tested HIV-positive and has now discovered that she is pregnant. Which statement indicates that she understands the risks of this diagnosis?

a. I know I will need to have an abortion as soon as possible.
b. Even though my test is positive, my baby might not be affected.
c. My baby is certain to have AIDS and die within the first year of life.
d. This pregnancy will probably decrease the chance that I will develop AIDS.

kkenney · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: C
Because of the presence of diabetes as a concurrent disease, the client will be closely monitored and a planned birth will be instituted to improve health outcomes for mother and fetus. Epidurals can be administered to obstetric clients who are diabetics. Although there is an increased risk for macrosomia and dystocia, the client will be prospectively managed and may still be able to have a vaginal birth. Because of the presence of diabetes as a concurrent disease, it is more likely that she will deliver a macrosomic infant who would be large for gestational age (LGA).

Answer to Question 2

ANS: B
The fetus is likely to test positive for HIV in the first 6 months, until the inherited immunity from the mother wears off. Many of these babies will convert to HIV-negative status. With the newer drugs, the risk for infection of the fetus has decreased. Also, the life span of an infected newborn has increased. The pregnancy will increase the chance of converting.