NCM 109 Flashcards

(36 cards)

1
Q

 Is an endocrine disorder in which the pancreas cannot
produce adequate insulin to regulate body glucose levels

A

DIABETES MELLITUS

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2
Q

A state characterized by the destruction
of the beta cells in the pancreas that
usually leads to absolute insulin
deficiency.

A

Type 1

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3
Q

A state that usually arises because of
insulin resistance combined with a
relative deficiency in the production of
insulin

A

Type 2

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4
Q

A condition of abnormal glucose
metabolism that arises during pregnancy.
Possible signal of an increased risk for
type 2 diabetes later in life.

A

GESTATIONAL
DIABETES

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5
Q

A state between “normal” and “diabetes”
in which the body is no longer using
and/or secreting insulin properly.

A

IMPAIRED
GLUCOSE
HOMEOSTASIS

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6
Q

a state
when fasting plasma glucose is
at least 110 but under 126 mg/dl

A

Impaired fasting glucose:

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7
Q

a
state when results of the oral
glucose tolerance test are at
least 140 but under 200 mg/dl in
the 1-hour sample

A

Impaired glucose tolerance:

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8
Q

high glucose concentration causes extra fluid to shift
and enlarge the amount of amniotic fluid.

A

Hydramnios

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9
Q

may create birth problems at the end of the
pregnancy because of CPD.

A

macrosomic infant

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10
Q

 Obesity
 Age over 25 years
 History of large babies (10 lb or more)
 History of unexplained fetal or perinatal loss
 History of congenital anomalies in previous pregnancies
 History of polycystic ovary syndrome
 Family history of diabetes (one close relative or two distant
ones)
 Member of a population with a high risk for diabetes (Native
American, Hispanic, Asian)

A

RISK FACTORS FOR DEVELOPING GESTATIONAL
DIABETES:

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11
Q

o Greater than or equal to 126 mg/dl or a nonfasting
plasma glucose greater than or equal to 200 mg/dl
meets the threshold for the diagnosis of diabetes and
does not need confirmation.
 NPO for 8 hrs. before the test

A

FASTING PLASMA GLUCOSE (FBS)

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12
Q

o Between 24 and 28 weeks’ gestation to determine if
they are at risk for gestational diabetes.

A

50-G GLUCOSE CHALLENGE TEST

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13
Q

o The woman drinks an oral 100-g glucose solution;
o A venous blood sample is then taken for glucose
determination at 1, 2, and 3 hours later.
o If two of the four blood samples collected for this test
are abnormal or the fasting value is above 95 mg/dl,
a diagnosis of diabetes is made

A

ORAL GLUCOSE TOLERANCE TEST (OGTT)

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14
Q

is an automatic pump with thin tubing,
which is placed subcutaneously, most often on the woman’s
abdomen.

A

insulin pump

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15
Q

Normal level of serum creatinine for pregnant women:

A

0.4 –
0.8 mg/dl

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16
Q

(i.e., a small amount of
amniotic fluid) may indicate fetal growth
restriction or a fetal renal abnormality

A

Oligohydramnios

17
Q

(i.e., an excessive amount of
amniotic fluid) may indicate gastrointestinal
malformation or poorly controlled disease.

A

Polyhydramnios

18
Q

is usually performed by week 36 of pregnancy to
assess fetal lung maturity

A

lecithin/sphingomyelin ratio by amniocentesis

19
Q

he most hazardous times for a fetus during a diabetesinvolved pregnancy are
o Because of his or her large size.

A

weeks 36 to 40 of pregnancy.

20
Q

 A form of high blood pressure in pregnancy
 A condition in which vasospasm occurs in both small and
large arteries during pregnancy
 Also called as TOXEMIA or PREECLAMPSIA
it occurs in about 5 to 7% of all pregnancies

A

pregnancy Induced Hypertension

21
Q

or the presence of
antiphospholipid antibodies in maternal blood

A

antiphospholipid syndrome

22
Q

o High blood pressure that is present before
pregnancy begins

A

Chronic Hypertension

23
Q

 BP 140/90 mmHg or
 Systolic BP > 30 mmHg; Diastolic 15 mmHg above
pregnancy level
 No proteinuria nor edema
 BP returns to normal after birth

A

GESTATIONAL HYPERTENSION

24
Q

 BP 140/90 mmHg
 Systolic BP > 30 mmHg; Diastolic 15 mmHg above
pregnancy level
 Proteinuria +1 to +2
 Weight gain 2 lbs/wk in 2nd trimester; 1 ln/wk in 3rd
trimester
 Mild edema in upper extremities or face

A

MILD PREECLAMPSIA

25
 BP 160/110 mmHg  Proteinuria: 3+ to 4+ on a random sample  Oliguria: 500 ml or less in 24 hrs  Pulmonary involvement: shortness of breath  Hepatic dysfunction  Epigastric pain due t
SEVERE PREECLAMPSIA
26
o Is most readily palpated over bony surfaces, such as over the tibia on the anterior leg, the ulnar surface of the forearm, and the cheekbones, where the sponginess of fluid-filled tissue can be palpated against bone.
Extreme edema
27
If there is swelling or puffiness at these points to a palpating finger but the swelling cannot be indented with finger pressure, the edema is described as
nonpitting.
28
Seizure or coma occurs  Signs and symptoms of preeclampsia
eclampsia
29
(5-8 mg/100ml)  Muscle relaxant  Prevent seizures
Magnesium sulfate
30
to reduce hypertension (5- 10 mg/IV)  Lowers BP by peripheral dilatation  Can Cause tachycardia
Hydralazine (Apresoline)
31
 Antidote for MgSO4 intoxication  10 ml of a 10% calcium gluconate must be
Calcium gluconate
32
 Halt seizures  5-10 IV, administer slowly - Dose may be repeated q 5 to 10 minutes (up to 30 mg/hr
Diazepam (Valium)
33
PRELIMINARY SIGNS BEFORE SEIZURE
 BP suddenly rises from additional spasm  Temperature rises (39.4-40°C) from increased cerebral pressure  Blurring of vision or severe headache from increased cerebral edema  Hyperactive reflexes  Epigastric pain and nausea from vascular congestion of the liver or pancreas
34
TONIC-CLONIC SEIZURES  Tonic Seizures: o Signs and Symptoms:
 Back arches  Arms and legs stiffen  Jaw closes abruptly  Respirations stop  Lasts for approx. 20 secs
35
Clonic Seizures: o Signs and Symptoms:
 Body muscles contract and relax repeatedly  Inhales and exhales irregularly  Incontinence of urine and feces may occur  Lasts up to 1 min  O2 therapy continued  MgSO4 or diazepam (Valium) may be administered via IV as an emergency measure
36
o Semi-comatose o Extremely close observation is necessary because seizure may cause premature separation of the placenta and labor may begin o Painful stimulus of contraction may initiate another seizure o Keep woman on side lying position o Keep NPO o Continue monitoring FHR and uterine contractions o Check for vaginal bleeding every 15 mins
Postictal State: