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A patient with pregestational diabetes mellitus delivers a neonate who is diagnosed with macrosomia. The nurse is aware that the neonate is at risk for additional long-term conditions related to maternal diabetes mellitus.
Which long-term effects may occur? Select all that apply.

A.

Impaired intellectual development.

B.

Development of metabolic syndrome.

C.

Shoulder injury related to birth size.

D.

Changes in genetic expression.

E.

Increased risk for chronic illnesses.

Question Solution

Correct Answer : A,B,D,E

Choice A rationale

Impaired intellectual development in children born to mothers with diabetes can occur due to fluctuating blood glucose levels, which can affect brain development.

 

Choice B rationale

Development of metabolic syndrome is more likely in children born to mothers with diabetes due to genetic predispositions and prenatal exposure to hyperglycemia.

 

Choice C rationale

Shoulder injury related to birth size, although a possible immediate complication, is not typically considered a long-term effect of maternal diabetes.

 

Choice D rationale

Changes in genetic expression can occur due to epigenetic modifications from exposure to maternal diabetes, potentially leading to various health issues later in life.

 

Choice E rationale

Increased risk for chronic illnesses, such as type 2 diabetes and cardiovascular diseases, is higher in children born to mothers with diabetes, due to genetic and environmental factors.


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View Related questions

Correct Answer is A

Explanation

Choice A rationale

Blood pressure of 160/110 indicates severe preeclampsia and warrants immediate intervention to prevent complications. Stopping oxytocin is part of the management of severe

preeclampsia to avoid exacerbating the condition.

Choice B rationale

Frequency of contractions every 3 minutes is within the normal range during labor induction and does not warrant stopping the infusion unless there are other concerns.

Choice C rationale

A fetal heart rate of 155 bpm with early decelerations may require close monitoring but does not necessarily warrant stopping the oxytocin infusion. Early decelerations are typically a

normal physiological response.

Choice D rationale

Frequency of contractions every 3 minutes is expected during active labor and is generally not a cause to stop the oxytocin infusion. The nurse should continue to monitor the labor

progression closely.

Correct Answer is D

Explanation

Choice A rationale

A low transverse uterine scar is considered the safest type of uterine incision for a VBAC because it is less likely to rupture compared to other types of scars. Therefore, a low transverse uterine scar would not disqualify the patient for VBAC.

Choice B rationale

Patient asking multiple questions does not disqualify her for VBAC. Patient education and ensuring the patient’s understanding and agreement with the procedure is an essential part of the process.

Choice C rationale

Induction of labor in the first pregnancy does not automatically disqualify a patient from attempting VBAC. The success of VBAC depends on multiple factors including the reason for the initial cesarean section.

Choice D rationale

A cesarean due to pelvic abnormalities would disqualify the patient for VBAC because the underlying pelvic condition that necessitated the initial cesarean section is likely still present and would increase the risk of complications during vaginal birth.

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