Practice Quiz

CNM Certified Nurse Midwife

Category - Postpartum

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A postpartum client has type 1 diabetes. The client gave birth 24 hours ago. During the immediate postpartum period, which of the following statements is the most accurate about her insulin needs?

  1. The insulin needs of the client decrease.
  2. The insulin needs of the client increase.
  3. The insulin needs of the client are the same as her insulin needs during her pregnancy.
  4. The insulin needs of the client are the same as her insulin needs before her pregnancy.
Explanation

Answer: A - The client’s insulin needs decrease during the immediate postpartum period. The placenta produces the hormone lactogen, which increases the client’s resistance to insulin. After birth, the hormone that antagonizes the action of insulin is not in the system because its source is removed through placental expulsion. The effect is an increased cellular response to insulin, which consequently decreases the need for insulin. The client may only need about one-half of the prenatal insulin dose during the immediate postpartum period.

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