In assessing the knowledge of a pregestational woman with type 1 diabetes concerning changing insulin needs during pregnancy, the nurse recognizes that further teaching is warranted when the client states:
a. "I will need to increase my insulin dosage during the first 3 months of pregnancy."
b. "Insulin dosage will likely need to be increased during the second and third trimesters."
c. "Episodes of hypoglycemia are more likely to occur during the first 3 months."
d. "Insulin needs should return to normal within 7 to 10 days after birth if I am bottle-feeding."
ANS: A
Insulin needs are reduced in the first trimester because of increased insulin production by the pancreas and increased peripheral sensitivity to insulin. "Insulin dosage will likely need to be increased during the second and third trimesters," "Episodes of hypoglycemia are more likely to occur during the first 3 months," and "Insulin needs should return to normal within 7 to 10 days after birth if I am bottle-feeding" are accurate statements and signify that the woman has understood the teachings regarding control of her diabetes during pregnancy.
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