A newly diagnosed type 1, insulin-dependent diabetic with good blood sugar control at 20 weeks' gestation asks how the diabetes will affect the baby. How should the nurse respond?
1. "Your baby may be smaller than average at birth."
2. "Your baby will probably be larger than average at birth."
3 "Your baby might have high blood sugar for several days."
4. "As long as you control your blood sugar, your baby will not be affected at all."
2
Explanation:
1. Poorly controlled type 1 diabetics who have developed vascular problems will have infants who are small-for-gestational-age (SGA) due to placental insufficiency.
2. The infant of a diabetic mother produces excessive amounts of insulin in response to the high blood sugar. This hyperinsulinism stimulates growth (or macrosomia) in the infant because the infant utilizes the glucose in the bloodstream.
3. Within minutes of delivery, the baby of an insulin-dependent diabetic can begin to develop low blood sugar.
4. The demands of pregnancy will make it difficult for the best of clients to control blood sugar on a regular basis.
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