Question

which statement by a client warrants further instruction by the nurse about the changing insulin needs of a diabetic client during pregnancy?
\episodes of hypoglycemia are more likely to occur during the first 3 months.\
\i will increase my insulin dosage by 5 units each month during the first trimester.\
\insulin dosage will likely need to be increased during the second and third trimesters.\
\breastfeeding will decrease my insulin needs to lower than my prepregnancy levels.\

Explanation:

To determine which statement needs further instruction, we analyze each option:

• Option 1: Hypoglycemia is more common in the first trimester due to hormonal and metabolic changes, so this is correct.
• Option 2: Insulin needs during the first trimester usually decrease (not increase by a set 5 units monthly) because of increased insulin sensitivity from hormonal shifts (like increased progesterone). So this statement shows a misunderstanding.
• Option 3: Insulin needs do increase in the second and third trimesters as insulin resistance rises with fetal growth and placental hormone production, so this is correct.
• Option 4: Breastfeeding can lower insulin needs, often to below prepregnancy levels, as lactation hormones affect glucose metabolism, so this is correct.

Answer:

B. "I will increase my insulin dosage by 5 units each month during the first trimester."