ATI: Medical Conditions

Question 1

An US shows a short cervix, presence of funneling, or effacement of the cervical os indicates what?

Answer 1

Cervical insufficiency

Question 2

What prophylactic action can HCP do for clients w/ cervical insufficiency?

Answer 2

Cervical cerclage which helps prevent premature cervical dilation

Question 3

A woman w/ cervical insufficiency is discharged home. What can she do to promote a soft uterus vs. a contracting uterus?

Answer 3

Increase hydration because dehydration causes uterine contractions

Question 4

When can cervical cerclage be applied to a woman who has cervical insufficiency?

Answer 4

12-14 weeks

Question 5

When is a cervical cerclage removed?

Answer 5

Between 37 and 38 weeks

Question 6

What are the risks for hyperemesis gravidarum for the fetus

Answer 6

• Intrauterine growth restriction
• SGA
• Preterm (if condition persists)

Question 7

Why is urinalysis the most important lab test to obtain in women w/ hyperemesis gravidarum?

Answer 7

Because it tests for ketones and acetones (breakdown of protein and fats)

Question 8

Why is metabolic alkalosis a finding in women with hyperemesis gravidarum?

Answer 8

D/t excessive vomiting

Question 9

What can we excpect with lab values for hematocrit (Hct) in women w/ hyperemesis gravidarum?

Answer 9

• elevated d/t hemoconcentration (all fluid is leaving)

Question 10

What do women w/ hyperemesis gravidarum get to replinish hydration?

Answer 10

Lactated ringers

Question 11

What vitamin/supplement can we give women w/ hyperemesis gravidarum?

Answer 11

pyridoxine (vitamin B12)

Question 12

Name the progression of diet advancement in women w/ hyperemesis gravidarum

Answer 12

1. Clear liquids
2. Crackers, dry toast, cereal (bland)
3. Soft diet
4. Normal diet

Question 13

Pica is due to what insufficiency?

Answer 13

Iron

Question 14

What levels of Hgb will indicate iron-deficiency anemia in a pregnant woman during 1st and 3rd trimesters?

Answer 14

Less than 11

Question 15

What levels of Hgb will indicate iron-deficiency anemia in a pregnant woman during 2nd trimester?

Answer 15

Less than 10.5

Question 16

What levels of Hct levels will indicate iron-deficiency anemia in a pregnant woman?

Answer 16

Less than 33%

Question 17

What levels of blood ferritin will indicate iron-deficiency anemia in a pregnant woman?

Answer 17

Less than 12

Question 18

What is the recommended iron intake for a pregnant woman?

Answer 18

37/mg day

Most prenatal vitamins typically have 30mg

Question 19

What medication can we give a woman w/ iron deficiency anemia?

Answer 19

Ferrous sulfate

Question 20

Pt. educaiton for ferrous sulfate?

Answer 20

• Take on empty stomach
• Take w/ orange juice
• Increase roughage and fluids to help w/ constipation

Question 21

What is the expected blood glucose level (in a pregnant woman) during fasting?

Answer 21

60-99

Question 22

What is the expected blood glucose level (in a pregnant woman) 2hrs after meals?

Answer 22

Less than 120

Question 23

What is a positive 1 hour blood glucose test?

What values?

Answer 23

130-140

Question 24

What if we have a positive 1 hour test?

Answer 24

We do a 3 hour test

Question 25

Is fasting needed for the 3 hour glucose test? | If so, how many hours?

Answer 25

Yes, fasting is needed 12 hours before the 3 hour glucose test

Question 26

What other substances need to be avoided before doing a 3 hour glucose test?

Answer 26

* Caffeine * Smoking

Question 27

What is the first form of treatment for women w/ gestational diabetes?

Answer 27

Exercise and diet

Question 28

What is the second form of treatment for women w/ gestational diabetes?

Answer 28

Medications ## Footnote ATI did not really talk about it, but glyburide may be used

Question 29

What are the criteria to classify a gesteraionl hypertension diagnosis?

Answer 29

* Onset of hypertension after 20 weeks gestation * BP reading of 140/90 * Reading must be 2 seperate times, 4 hours apart * No proteinuria

Question 30

What is the criteria for preeclampsia?

Answer 30

* Gestational hypertension * WITH proteinuria of greater or equal to 1+ Edema and headaches can be present as well

Question 31

What do we see in severe preeclampsia?

Answer 31

Proteinuria 3+ Ankle clonus BP 160/110 or greater Severe headache Blurred vision Creatinine 1.1 or more Oliguria Extensive peripheral edema Hyperreflexia Epigastric or RUQ pain Thrombocytopenia (low number of platelets in the blood)

Question 32

What distinguishes eclampsia vs preeclampsia?

Answer 32

Eclmapsia we see seizure activities We see headaches, epigstric pain, RUQ, hyperrflexia

Question 33

What is HELLP?

Answer 33

1. H:hemolysis; anemia & jaundice 2. EL: Elevated liver enzymes; high ALT/AST, epigastric pain, n/v 3. LP: Low platelets; less than 100,000; thrombocytopenia, bleeding gums, peteichae and possible DIC

Question 34

What is the best way to mantain a regular flow rate of magnesium sulfate?

Answer 34

Use an infusion control device

Question 35

What first needs to be done if you notice magnesium sulfate toxicity?

Answer 35

Stop infusion!

Question 36

What is the antidote for magensium sulfate?

Answer 36

Calcium gluconate

Question 37

What are som s/s of magnesium sulfate toxicity?

Answer 37

* Depressed resp. rate * Absent deep tendon reflexes * Urine output less than 30ml * Decreased LOC * Cardiac dysrhythmias