Biology Forums - Study Force

The patient with insulin-dependent type 2 diabetes and an HbA1c of 5.0 is planning to become pregnant soon. What anticipatory guidance should the nurse provide this patient?
 
  1. Insulin needs decrease in the first trimester and increase during the third trimester.
  2. The risk of ketoacidosis decreases during the length of the pregnancy.
  3. Vascular disease that accompanies diabetes slows progression.
  4. The baby is likely to have a congenital abnormality because of the diabetes.

1
Rationale 1: Insulin needs frequently decrease early in the first trimester and increase after that.
Rationale 2: The risk of ketoacidosis increases during pregnancy.
Rationale 3: Vascular disease progresses more rapidly during pregnancy, especially if blood sugar control is not good. Problems such as nephropathy and retinopathy can result.
Rationale 4: Infants of diabetic mothers have a 5 to 10 greater risk of having a congenital abnormality. This risk increases to 20 to 25 if the HbA1c is over 10.