QUESTION: "A client with diabetes mellitus that is well controlled reports that she participated in strenuous aerobic exercise before becoming pregnant. She asks the nurse if she can continue exercising. Which of the following would be the nurse's best response?"
CHOICES
( X ) a.) "You probably should discontinue your strenuous exercise program while you are pregnant so you don't injure the fetus."
( X ) b.) "You need to curtail your exercise program a little so that you don't overexert yourself while you are pregnant."
( O ) c.) "You can continue exercising while pregnant, but make sure that you eat a carbohydrate or protein snack before exercising."
( X ) d.) "It's probably a good idea for you to check your blood sugar before beginning any exercise program."
RATIONALE: Although pregnancy is not an optimum time to begin a vigorous exercise program, a client whose diabetes is well controlled and who has regularly engaged in exercise prior to becoming pregnant may continue to do so. However, she should be reminded to eat a carbohydrate or protein snack before exercising to prevent hypoglycemia. The fetus is well protected in the amniotic sac, and exercise is not harmful. Insulin requirements may change if exercise is discontinued. A client with well-controlled diabetes does not need to stop exercising or curtail her exercise program during pregnancy. Insulin requirements may change if exercise is discontinued. Because the client's diabetes is well controlled, the client's blood glucose levels most likely are within normal limits. Therefore, checking blood glucose levels again before exercising is not necessary. NURSING PROCESS STEP: Implementation CLIENT NEEDS CATEGORY: Physiological integrity CLIENT NEEDS SUBCATEGORY: Physiological adaptation
