Question

y. what information should vou include as part of dischorge teaching? Suson ise 26-year-old 61PO at 6 weeks of gestation with type 2 diabetes. Her BMI is 32. Her hemoglobin Au is 9. She uses glyburide 10 mg pe daily. The physician has switched her to insulin gt this time What is the nursing priority at this time? What should Susan be tought about insulin needs in pregnancy? What additional risk foctor does Suson have? How should Susan be counseled reaarding weight gain in pregnancy? Whot advice con be given to Susan regarding exercise? 3 4 Jane is o 33-year-old 64 P3. She has just found out that she is pregnant and is glarmed becquse she was using a selective serotonin reuptake inhibitor (5SRI for depression. She was also using oral contraceptives. She acknowledges she may have forgotten to take some of the oral contraceptive pills, Jane's last menstrual period was January 8. Today is February 20. What can you tell Jane about her exposure to the SSRI? 2, Jane has an ultrasound, which reveals she is 5 weeks pregnant, She then consults a genetic counselor for information about the medication exposure. Because of the timing of her exposure, the counselor informs 1, Jane has stopped taking her SSRI but is having trouble caping with symptoms of depression She attends therapy but feels she needs the medication also. What are the principles of medication use during her there would likely be an "all or nothing" effect, What does this mean? 3 pregnancy that must be considered?

Answer 1

Susan is a 26-year-old G1 P0 at 6 weeks of gestation with type 2 diabetes. Her BMI is 32. Her haemoglobin A1c is 9. She takes glyburide 10mg daily. The physician has switched her to insulin at this time.

1. What is the nursing priority at this time?

The nursing priority is to provide effective education about insulin use, diet, and exercise to enable Susan to achieve normal glucose levels as quickly as possible. Probably to get her to lose weight as she is obese.

2. What should Susan be taught about insulin needs in pregnancy?

Insulin needs may decline during the first trimester and then increase during the second and third trimesters of pregnancy.
she should gain 11-20 pounds in pregnancy

3. What additional risk factor does Susan have?

Infection
Bleeding at the placental site
Maternal or fetal stress
Uterine overdistension

4. How should be Susan be counselled regarding weight gain in pregnancy?

Educate her to lose weight as she is obese to avoid more complications

5. What advice can be given to Susan regarding exercise?

Gestational diabetes occurs when the body becomes resistant to the insulin it produces during pregnancy. This happens as a result of the increased insulin demands imposed by pregnancy. When you have gestational diabetes, your blood glucose levels run higher than they normally would.

One way to lower blood glucose levels is to exercise. When we exercise, our muscles take in more glucose. When this effect wears off, our muscles remain more sensitive to insulin for some time.

Jane is a 33-year-old G4P3. She has just found that she is pregnant and is alarmed because she was using a serotonin reuptake inhibitor for depression. She was also using oral contraceptives. She acknowledges she may have forgotten to take some of the oral contraceptives. Janes last menstrual period was January 8. Today is February 20.

1. What can you tell Jane about her exposure to the SSRI?

SSRIs are the most commonly prescribed antidepressants during pregnancy. Risks and benefits, including previous treatment success and failure, should be taken into account before starting or switching therapy.

2. Jane has an ultrasound which reveals she is 5 weeks pregnant. She then consults a genetic counsellor for information about medication exposure. Because of the timing of her exposure, the counsellor informs her there would likely be an "all or nothing" effect. What does it mean?

All or nothing means there is no intermediate state or partial result.

3. Jane has stopped taking her SSRI but is having trouble coping with symptoms of depression. She attends therapy but feels she needs medication also. What are the principles of medication use during pregnancy that must be considered?

The main aim of treatment with antidepressants is to relieve the symptoms of depression, such as feeling very sad and exhausted and prevent them from coming back. The medications are designed to restore emotional balance and help people to get on with everyday life. They are also taken to relieve symptoms such as restlessness, anxiety, sleep problems.