MATERNAL CHILD NURSING 5TH EDITION
2026 HIGH RISK PREGNANCY
COMPLICATIONS MANAGEMENT AND
INTERVENTION GUIDE
◉1
If a patient with diabetes does not take in enough carbohydrates, the
body resorts to breaking down fats for energy. The by-product of fat
metabolism is ketones. Therefore the nurse monitors the urine for
ketones. The amount of ketones in the urine helps detect inadequate
carbohydrate intake. Nonstress tests will help assess the well-being
of the fetus. Glycosuria does not accurately reflect the blood glucose
levels because of a lowered renal threshold for glucose during
pregnancy. The nurse obtains a baseline sonogram to assess
gestational age in the first trimester.
Test-Taking Tip: Relax during the last hour before an examination.
Your brain needs some recovery time to function effectively.
Answer: Which action does the nurse take to determine whether the
carbohydrate intake is inadequate in a pregnant patient with
diabetes?
1
,Monitor for urine ketones.
2
Evaluate the nonstress test results.
3
Determine the degree of glycosuria.
4
Schedule a baseline fetal sonogram.
◉1
In the first trimester of pregnancy, there is an increase in insulin
production and a decrease in hepatic glucose production because of
the rising levels of estrogen and progesterone. This lowers the
glucose levels and makes the pregnant patient prone to
hypoglycemia. Cyanosis of lips, increasing fatigue, and generalized
edema are signs of cardiac decompensation in a pregnant patient
with preexisting cardiac disease. It occurs because the heart is
unable to maintain sufficient cardiac output because of pregnancy.
Answer: Which condition does the nurse expect to find in the
medical record of a pregnant patient with diabetes mellitus?
1
Hypoglycemia
2
Cyanosis of lips
,3
Increasing fatigue
4
Generalized edema
◉3
Terbutaline (Brethine) is a beta-mimetic drug administered for
tocolysis to stop preterm labor. It may lead to hyperglycemia and
cause ketoacidosis in the pregnant patient. Dyspnea on exertion may
be seen in a pregnant patient with acquired cardiac disease.
Infection in pregnant women happens because of an alteration in the
normal resistance of the body to infection. Hypoglycemia occurs if
there is an increase in the insulin levels.
Answer: Which condition should the nurse be alert for after
administering terbutaline (Brethine) to a pregnant patient with
diabetes mellitus?
1
Dyspnea
2
Infection
3
Ketoacidosis
4
, Hypoglycemia
◉2
If a patient has given birth to an infant with microcephaly in the
past, there is a possibility that the patient has phenylketonuria
(PKU). PKU results from a deficiency in the enzyme phenylalanine
hydrolase. Preterm birth is a possibility in pregnant women with
untreated hypothyroidism. PKU affects brain development and
function in the child; it does not cause miscarriage. Genetic
counseling is more important for patients who have hereditary
disorders, which can be passed on to the child.
Test-Taking Tip: Because few things in life are absolute without
exceptions, avoid selecting answers that include words such as
always, never, all, every, and none. Answers containing these key
words are rarely correct.
Answer: How does the nurse advise the patient who has given birth
to an infant with microcephaly in the past and is now planning for
the next child?
1
"There is a higher chance of having a preterm birth."
2
"You should be screened for phenylketonuria (PKU)."
3
2026 HIGH RISK PREGNANCY
COMPLICATIONS MANAGEMENT AND
INTERVENTION GUIDE
◉1
If a patient with diabetes does not take in enough carbohydrates, the
body resorts to breaking down fats for energy. The by-product of fat
metabolism is ketones. Therefore the nurse monitors the urine for
ketones. The amount of ketones in the urine helps detect inadequate
carbohydrate intake. Nonstress tests will help assess the well-being
of the fetus. Glycosuria does not accurately reflect the blood glucose
levels because of a lowered renal threshold for glucose during
pregnancy. The nurse obtains a baseline sonogram to assess
gestational age in the first trimester.
Test-Taking Tip: Relax during the last hour before an examination.
Your brain needs some recovery time to function effectively.
Answer: Which action does the nurse take to determine whether the
carbohydrate intake is inadequate in a pregnant patient with
diabetes?
1
,Monitor for urine ketones.
2
Evaluate the nonstress test results.
3
Determine the degree of glycosuria.
4
Schedule a baseline fetal sonogram.
◉1
In the first trimester of pregnancy, there is an increase in insulin
production and a decrease in hepatic glucose production because of
the rising levels of estrogen and progesterone. This lowers the
glucose levels and makes the pregnant patient prone to
hypoglycemia. Cyanosis of lips, increasing fatigue, and generalized
edema are signs of cardiac decompensation in a pregnant patient
with preexisting cardiac disease. It occurs because the heart is
unable to maintain sufficient cardiac output because of pregnancy.
Answer: Which condition does the nurse expect to find in the
medical record of a pregnant patient with diabetes mellitus?
1
Hypoglycemia
2
Cyanosis of lips
,3
Increasing fatigue
4
Generalized edema
◉3
Terbutaline (Brethine) is a beta-mimetic drug administered for
tocolysis to stop preterm labor. It may lead to hyperglycemia and
cause ketoacidosis in the pregnant patient. Dyspnea on exertion may
be seen in a pregnant patient with acquired cardiac disease.
Infection in pregnant women happens because of an alteration in the
normal resistance of the body to infection. Hypoglycemia occurs if
there is an increase in the insulin levels.
Answer: Which condition should the nurse be alert for after
administering terbutaline (Brethine) to a pregnant patient with
diabetes mellitus?
1
Dyspnea
2
Infection
3
Ketoacidosis
4
, Hypoglycemia
◉2
If a patient has given birth to an infant with microcephaly in the
past, there is a possibility that the patient has phenylketonuria
(PKU). PKU results from a deficiency in the enzyme phenylalanine
hydrolase. Preterm birth is a possibility in pregnant women with
untreated hypothyroidism. PKU affects brain development and
function in the child; it does not cause miscarriage. Genetic
counseling is more important for patients who have hereditary
disorders, which can be passed on to the child.
Test-Taking Tip: Because few things in life are absolute without
exceptions, avoid selecting answers that include words such as
always, never, all, every, and none. Answers containing these key
words are rarely correct.
Answer: How does the nurse advise the patient who has given birth
to an infant with microcephaly in the past and is now planning for
the next child?
1
"There is a higher chance of having a preterm birth."
2
"You should be screened for phenylketonuria (PKU)."
3
