During a prenatal visit, the nurse is explaining dietary management to a woman with pregestational diabetes. The nurse evaluates that teaching has been effective when the woman states:
1. "I will need to eat 600 more calories per day since I am pregnant.".
2. "I can continue with the same diet as before pregnancy, as long as it is well ba-lanced.".
3. "Diet and insulin needs change during pregnancy.".
4. "I will plan my diet based on results of urine glucose testing.".
3
1. Incorrect. The diet is individualized to allow for increased fetal and metabolic require-ments, with consideration of such factors as prepregnancy weight and dietary habits, overall health, ethnic background, lifestyle, stage of pregnancy, knowledge of nutrition, and insulin therapy.
2. Incorrect. Energy needs are usually calculated on the basis of 30 to 35 calories per kilo-gram of ideal body weight. The diet is individualized to allow for increased fetal and meta-bolic requirements.
3. Correct. The diet is individualized to allow for increased fetal and metabolic require-ments. Diet and insulin needs change during the pregnancy in direct correlation to hormonal changes and energy needs. In the third trimester, insulin needs may double or even quadruple.
4. Incorrect. Dietary management during diabetic pregnancy must be based on blood, not urine, glucose changes.
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