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NUR 318 > module 6 > Flashcards

module 6 Flashcards

1
Q

diabetes

A

the most common endocrine disorder associated with pregnancy. if an individual is diagnosed with diabetes mellitus their pregnancy is considered high risk. The Key is strict control of glucose
-caused by defects in insulin secretion, insulin action, or both

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2
Q

preexisting conditions

A

cardiovascular disorders, respiratory, gastrointestinal, integumentary, and CNS disorders, substance abuse

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3
Q

pre-gestational diabetes

A

patient had diabetes proor to pregnancy

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4
Q

gestational diabetes mellitus

A

impaired tolerance to glucose with rist onset or recognition during pregnancy. usually determined at 24-28 weeks

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5
Q

risks to newborns with poor glucose control

A
  • congential abnormalities
  • spontaneous abortion
  • macrosomia: birth trauma and dystocia
  • death
  • respiratory distress syndrome because of c-sectipon
  • intrauterine fetal demise
  • hypoglycemia post birth
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6
Q

contributing factors to gestational diabetes

A

obesity, maternal age greater than 25, previous delivery of lart infant/stillborn

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7
Q

two step method for diagnosis of gestational diabetes

A

step 1: 1 hr 50g oral glucose screen. a positive is >130-140 mg/dL
step 2: 3 hr 100g oral glucose tolerance test.
scale. myst have exceeded 2 or more blood glucose values

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8
Q

effects of GD on mother

A
  • hypertension
  • ketoacidosis
  • preterm labor due to preterm ROM
  • UTIs from glucose in urine
  • dystocia
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9
Q

assessment and nursing diagnsois for gestational diabetes

A
  • interview
  • physical exam: assess chronic complications
  • labs: renal function, UA and culture, HgA1c: <6.5%
  • education on frequent medical and self monitoring
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10
Q

antepartum care

A
  • diet and exercise
  • insulin therapy/ self monitoring of glucose
  • urine tests
  • fetal survailence: fetal kick count, degree of macrosomia, nonstress test
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11
Q

Type 1 DM care vs. GDM care

A

type 1: inuslin therapy is the most important than diet and exercise and finally fetal suvailence

GD

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12
Q

intrapartum care for GDM

A

monitor for complications, may requrie c-section. glucose should stag btw 80 and 110

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13
Q

after brith care GDM

A

insulin requirements decrease substatntially, encourage breast feeding (can also help infant with hypoglycemia), contraception: IUD

  • reassess patient at 6-12 wks PP
  • this person is at increased risk for type 2 DM later on
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14
Q

iron deficiency anemia

A

comon un 75-95% of pregnant women. it increases the risk for preterm delivery, perinatal mortality, and poor motor function of the infant.

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15
Q

nursing assessment of anemia

A

history and physical, PICA? nutrtional intake,

  • look for SOB, pallor, dizziness, fatigue
  • H and H <11g/dL and <35% is considered anemia
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16
Q

nursing management for anemia

A

education of good diet, taking vitamins and iron supplements with a source of vitamin C. can cause constipation so also increase fiber.
-things high in iron: meats green leafy veg, leumes, dried fruits, whole grains

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17
Q

PUPS

A

pruritic urticarial papulases and plaques of prgnancy

may be given cortizone

18
Q

intrahepatic cholestasis

A

usually in the 3rd trimester it is an elevated serum bile acid and elevated LFTs, could cause jaundice and is itchy
fetal complications asphyxia events, meconium staining, stillbert, preterm birht

19
Q

risk factors for pregnancy-related hypertension

A
  • primigravida, > 35 yrs
  • anemia
  • chronic hypertension
  • obesity
  • diabetes
  • chronic renal disease
  • twins +
  • family members had it
20
Q

what is the cutoff for diagosis of preeclampsia

A

140/90
>300 mg of protein in the urine
-on 2 occasions 4-6 h apart

21
Q

complications of HTN

A
  • abruptico placentae
  • DIC
  • IUGR
  • preeclampsia and eclampsia
  • stroke
  • HELLP
  • placcental insuff and preterm delivery
  • death
22
Q

chronic hypertension

A

BP > 140/90 mm Hg before pregnancy or before 20 weeks of gestation

23
Q

gestational hypertension

A

elevated BP identified after 20 weeks of gestation without proteinuria
BP returns to normal by 6 wks pp

24
Q

preeclmpsia

A

gestationa lypertension plus proteinuria

mild or severe

25
Q

eclampia

A

onset of seizures in women with preeclampsia

26
Q

HELLP

A

variant of preeclampsia or eclampsia involving hemolysis, thrombocytopenia, liver dysfunction
-life threatening
H: hemolysis leads to anemia and jaundice
EL: elevated liver enzymes resulting in elevated ALTs and ASTs, epigastric pain, NV
LP: low platlets < 100: thrombocytopenia, abnormal bleeding and clotting

27
Q

nursing assessment care for preeclampsia

A

H and P
labs: CBC, electrolytes, BUN, creatinine, liver enzymes
urine: proteinuria? if greater than 102 + do a 24 h urine
VS assessing DTR, clonus, edema, orientation and kick counts

28
Q

management fo preeclampsia

A

mild can be managed at home but severe needs to be hospitalized to avoid seizures and HELLP
-medicatioon admin

29
Q

taking BP with preeclampsia

A

take the BP while she is sitting with her arm at heart level and check DTRs with VS. check for pitting edema and locations

30
Q

What does HELLP increase the risk for?

A
  • pulmonary edema
  • acute renal failure
  • liver hemorrhage
  • DIC
  • placental abruption
  • respiratory distres
  • sepsis
  • stroke
31
Q

management of HELLP

A

lowering BP with hydralazine or labetalol
prevention of seizures with mag sulfate
blood component therapy with fresh frozen plasma or packed RBC, and platelets
delivery of fetus as soon as possible: steroids given to help wiht fetal lung maturity

32
Q

electronic vs manual bp

A

not interchangable. manual is more accurate

33
Q

intervention for GH and preeclampsia

A

saftey
deliver as soon as 37 weeks
outpatinet and home management

34
Q

care for severe preeclampsia

A

perinatologist services
antihypertensives
corticosteroins
mag sulfate

35
Q

eclampsia immediate care

A

maintain patient airway and saftey during seixure
stabilize mother after seizure
mag sulfate
FHR

36
Q

chronic hypertension can cause what in pregnancy

A

superimposed preeclampsia

Aldomet or methyldopa can be used to lower BP in preg

37
Q

spontaneous abortion of miscarraing

A

-vaginal bleeding, cramping, passing products of conception
nursing management
-assess bleeding, cramping, VS and state of mind
-support and allow for the grieving process
-if mother is RH- and fetus was RH+ assess need for ROGAM

38
Q

what is a missed aboriton

A

one where the fetus has aborted but has not be expelled

39
Q

placental abruption vs placenta previa

A

chart

40
Q

late pregnancy bleeding

A

cord insertion and placental cariations

vasa previa: blood vessels un umbilical cord are located above the cervix

41
Q

DIC

A

disseminated intravascular coagulation
triggered by severe preeeclampsia, HELLP, and gram negatic sepsis
management to treat underlying cause and assess for signs of bleeding
-causes hemorrhaging

42
Q

hyperemesis gravidarum

A

N and V in early pregnancy that prevents the woman from ingesting adequTE NUTRITION
IV fluids may be required for hydration
medications: phenergan, compazine
corticosteroids for the risk of facial clefting
-should subside by 20 weeks
-3 meals 2 snacks
-eat what sounds good not what “balanced”
-dairy stays down easier
-high protein at bedtime to sustain Blood glucose

NUR 318 (10 decks)

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