Exam 1 - Concurrent Disorders of Pregnancy

Question 1

baby’s head is large for their gestational age

Answer 1

Macrosomia

Question 2

when babies get stuck in the birth canal

Answer 2

Shoulder distocia

Question 3

What are the neonatal risks of a Mom with preexisting diabetes?

Answer 3

(1) Neonatal hypoglycemia
(2) Neonatal hypocalcemia
(3) Neonatal hyperbilirubinemia
(4) Respiratory distress syndrome
(5) T2D for baby later in life

Question 4

What makes pregnancy a naturally diabetogenic state?

Answer 4

Hyperinsulinemia
Hyperglycemia
Mild fasting hypoglycemia

Question 5

What is responsible for creating resistance to insulin in maternal cells in late pregnancy?

Answer 5

Estrogen, progesterone, and hPL

Question 6

Why does fetuses get hyperglycemia and hyperinsulinemia?

Answer 6

b/c glucose easily crosses the placenta, but insulin does NOT

Question 7

Risk factors for GDM

Answer 7

(1) Overweight (BMI 25-29), obese (BMI > 30)
(2) Pregnant person over 25 yo
(3) Previous birth outcome with GDM association
(4) GDM in previous pregnancy
(5) H/o abnormal glucose intolerance
(6) Hx of diabetes in close relative
(7) Part of high-risk ethnic group

Question 8

What is the standard of care for screening for GDM?

Answer 8

24-28 weeks

Question 9

The first glucose test is what?

Answer 9

Glucose challenge test (GCT)

Question 10

What is the second glucose test?

Answer 10

Oral glucose tolerance test (OGTT)

Question 11

3-hour, 100g load describes which glucose test?

Answer 11

Oral glucose tolerance test (OGTT)

Question 12

1-hour, 50g load describes which glucose test?

Answer 12

Glucose challenge test (GCT)

Question 13

How is GDM diagnosed?

Answer 13

OGTT values should show at least 2 abnormal values (elevated)

Question 14

Symptoms of GDM

Answer 14

Increased thirst
Needing to urinate more frequently
Nausea
Dry mouth
Tiredness
Blurred vision

Question 15

Name 3 risks of GDM for the pregnant person

Answer 15

Higher risk of preeclampsia
Higher risk of cesarean delivery
Increased risk of T2D later in life

Question 16

Name at least 3 risks of GDM for the fetus/neonate

Answer 16

(1) Macrosomia
(2) Neonatal hypoglycemia
(3) Hyperbilirubinemia
(4) Shoulder dystocia
(5) Birth trauma

Question 17

The biggest thing we can do to help people with GDM have a healthy pregnancy is….

Answer 17

management of blood sugars through diet and exercise

Question 18

How should pregnant people with GDM manage their sugars?

Answer 18

Take blood sugars at home and track

Question 19

Fasting blood sugar target should be:

Answer 19

<95 mg/dL

Question 20

1-hr postprandial sugar target should be:

Answer 20

<=140 mg/dL

Question 21

2-hr postprandial sugar target should be:

Answer 21

<=120 mg/dL

Question 22

____ is the first line pharmacologic therapy for GDM

Answer 22

insulin

Question 23

During labor and birth process, blood glucose is monitored hourly to maintain levels at ____ to ____ mg/dL

Answer 23

80-110 mg/dL

Question 24

T/F: Most pts with GDM return to normal glucose levels after birth

Answer 24

True

Question 25

Patients who have had GDM have up to a __% chance of developing T2D later in life!

Answer 25

70

Question 26

Name one long-term implication of GDM for baby

Answer 26

Increased risk of childhood / adult obesity

Question 27

3 types of anemia

Answer 27

(1) Iron-deficiency anemia (2) Sickle cell disease (3) Thalassemias

Question 28

____ is the most common hematologic abnormality

Answer 28

Anemia

Question 29

Blood d/o that occurs when the body doesn’t have enough iron to produce healthy RBCs

Answer 29

Iron-deficiency anemia (IDA)

Question 30

To properly diagnose IDA, what do we measure?

Answer 30

Hb level and ideally ferritin

Question 31

Risk factors for IDA include...

Answer 31

(1) poor diet (2) GI disease (3) Short interval b/w pregnancies

Question 32

IDA is associated with increased risk of what 3 things?

Answer 32

(1) Low-birth weight (2) Preterm delivery (3) Perinatal mortality

Question 33

Nursing care for IDA include...

Answer 33

(1) Identify abnormal lab values (Hb < 11 g/dL) (2) Management of low iron w/ supplements/food

Question 34

What is a low Hb level that is considered anemic in pregnancy?

Answer 34

Hb < 11 g/dL

Question 35

What is the supplement for IDA?

Answer 35

Ferrous sulfate 325 mg BID

Question 36

Side effects of ferrous sulfate include what 3 things?

Answer 36

(1) constipation (2) GI upset (3) poor absorption

Question 37

What can increase absorption of ferrous sulfate?

Answer 37

Vitamin C

Question 38

What can decrease absorption of ferrous sulfate?

Answer 38

Calcium - avoid taking with milk products, etc.

Question 39

Name at least 3 examples of iron-rich foods.

Answer 39

(1) green, leafy veg (2) meats (3) nuts (4) beans (5) legumes

Question 40

A group of autosomal recessive disorders involving abnormal Hg (HgS)

Answer 40

Sickle Cell Disease

Question 41

Spectrum of disorders characterized by reduced synthesis of globin chains, leading to microcytic anemia

Answer 41

Thalassemia