Question

The home health care nurse makes a visit to the pregnant client diagnosed with type 1 diabetes mellitus. The client states, 'I have been nauseated for 24 hours.' It is most important for the nurse to ask which question?

A. 'Have you been taking your insulin as prescribed?'
B. 'Are you experiencing any vaginal bleeding or cramping?'
C. 'Have you been eating a well-balanced diet?'
D. 'How often are you monitoring your blood glucose levels?

Answer 1

The most critical question for the nurse to ask is whether the pregnant client with type 1 diabetes has been taking her insulin as prescribed, due to the importance of insulin in managing blood glucose levels and preventing serious complications like hyperglycemia and diabetic ketoacidosis.

Step-by-step explanation:

The most important question a nurse should ask a pregnant client diagnosed with type 1 diabetes mellitus, who has been experiencing nausea for 24 hours, is 'Have you been taking your insulin as prescribed?' This is the most critical concern because insulin management is central to controlling blood glucose levels in type 1 diabetes, and improper insulin use can lead to severe complications for both the mother and the fetus.

It is also important to inquire about the client's diet and glucose monitoring habits, but ensuring that insulin therapy is being followed appropriately is the immediate priority given the risk of hyperglycemia and potential diabetic ketoacidosis (DKA), which can be characterized by nausea and vomiting among other symptoms. These conditions are medical emergencies, especially during pregnancy.

If the client is indeed taking insulin as prescribed, the nurse may proceed to ask additional questions, such as whether the client is experiencing any vaginal bleeding or cramping, which could indicate pregnancy complications, and how often they are monitoring their blood glucose levels, as frequent monitoring can help manage the condition effectively.