NCLEX Question for Diabetic CLient who is planning for a pregnancy

The nurse includes the importance of self-monitoring of glucose in the care plan for a diabetic client planning a pregnancy. The goal of this monitoring is to prevent

a.    congenital malformations in the fetus

b.    maternal vasculopathy

c.    accelerated growth of the fetus.

d.    delayed maturation of fetal lungs.

Correct Answer A. There is increasing evidence that the degree of control for an insulin-dependent diabetic woman prior to conception greatly affects the fetal outcome. Studies find that poor maternal glucose control underlies the incidence of congenital malformations in the infants of diabetic mothers.

In diabetic woman with vascular disease, White’s class D, or one who has had diabetes for at least 20 years, even careful control of glucose at this point will not prevent these cardiovascular changes.

Macrosomia, excessive fetal growth, can occur in infants of diabetic mothers from hyperinsulinism; however, this is a concern in alter pregnancy, not at conception.

Infants of diabetic mothers have a higher incidence of respiratory distress syndrome because hypersulinism has a delaying effect on fetal lung maturation; however, this is a concern in later pregnancy.

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