NCLEX question! need help

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A woman with type 1 diabetes is returned to the recovery room one hour after an uneventful delivery of a 9lb., 8 oz., baby boy. The nurse would expect the woman's blood sugar to do which of the following?

1. Change from 220 to 180 mg/dl.

2. Change from 110 to 80 mg/dl.

3. Change from 90 to 120 mg/dl.

4. Change from 100 to 140 mg/dl.

The answer is 2.

Is there anyone that could explain the pathophysiology? Thanks!!!

LOL I've spent the whole day lookin for the answer. XD

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Specializes in Med Surge, Tele, Oncology, Wound Care.

It should remain normal, it was an uneventful delivery and it was an hour (lucky mom after a 9lb baby!)

The mom should have normal blood sugar going in (the question does not say whether she forgot a dose of insulin, or whether she had poor glycemic control...in the perfect world theoretically she should have normal blood sugar).

This is one of those trick questions...

Even if you didn't know the physiology of diabetes you can guess...

Rule out number 1 and 4 because they contain an abnormal blood sugar level with a normal level (the answers are practially both the same- so rule out), rule out number 3 because the sugar should go down not up- after working to push a baby (using sugar stores). So the answer left is 2. Again in the perfect world, diabetic or not the sugar should be normal...

I can see how this could be very misleading, I think I had this question on the Kaplan...

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The reason might be that the woman had been NPO during labor for a long peroid of hours . so you will expect the post delivery blood sugar to decrease. The reason the answer is not A was because you 220 is high blood sugar already and pregnant women blood sugar are suppose to already in control before labor start.

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Yay! Thanks for the answer! :) and Yes, its from Kaplan book. :D the very first question.

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Thanks for the answer. really appreciate it

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Just answering based on my gut, but I will give it a shot...

From what I remember about newborns and a mom who has DM, the important issue is the baby's blood sugar bc they have been getting their BS from their mom and then suddenly after birth, they arent. So the baby is at risk for hypoglycemia. I do not remember anything specific about DM moms (although I could be wrong).

And remember, with NCLEX, never assume anything. There is no indication that mom's BS isnt under control. Also, I have a feeling that the BS of mom should be going down bc now that she isnt pregnant, her body has less stress and stress increases BS (just an educated guess that this is the case in this example).

1. Change from 220 to 180 mg/dl - no indication that she had high BS to begin with

2. Change from 110 to 80 mg/dl - both normal numbers, going down.

3. Change from 90 to 120 mg/dl - both normal-ish numbers, but going up.

4. Change from 100 to 140 mg/dl - normal-ish/high, numbers going up.

So, by process of elimination, I found answer number 2 to make the most sense. There isnt always exact patho behind every answer and more than one answer could realistically be true. NCLEX wants the "best" answer to the question at hand, based on only the information given.

Not sure that helped, but just thought I'd give it a try.

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Just answering based on my gut, but I will give it a shot...

From what I remember about newborns and a mom who has DM, the important issue is the baby's blood sugar bc they have been getting their BS from their mom and then suddenly after birth, they arent. So the baby is at risk for hypoglycemia. I do not remember anything specific about DM moms (although I could be wrong).

And remember, with NCLEX, never assume anything. There is no indication that mom's BS isnt under control. Also, I have a feeling that the BS of mom should be going down bc now that she isnt pregnant, her body has less stress and stress increases BS (just an educated guess that this is the case in this example).

1. Change from 220 to 180 mg/dl - no indication that she had high BS to begin with

2. Change from 110 to 80 mg/dl - both normal numbers, going down.

3. Change from 90 to 120 mg/dl - both normal-ish numbers, but going up.

4. Change from 100 to 140 mg/dl - normal-ish/high, numbers going up.

So, by process of elimination, I found answer number 2 to make the most sense. There isnt always exact patho behind every answer and more than one answer could realistically be true. NCLEX wants the "best" answer to the question at hand, based on only the information given.

Not sure that helped, but just thought I'd give it a try.

I can see your point. Thanks for the answer. I appreciate it. :)

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Thanks for presenting this question.

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