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Nursing > Pregnancy At Risk > Flashcards

Pregnancy At Risk Flashcards

0
Q

Maternal effects of alcohol use during pregnancy

A

Malnutrition
Bone marrow suppression
Increased incidence of infections
Liver disease

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1
Q

Fetal alcohol syndrome

A

Physical and mental damage in a child due to alcohol exposure while in the womb

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2
Q

Neonatal effects of alcohol use during pregnancy

A

Fetal alcohol spectrum disorders
Abnormal structural development and CNS dysfunction
Growth deficiencies
Classic dystrophic facial features
Associated anomalies: cardiac. Optic. Auditory. Renal. Skeletal system.

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3
Q

Maternal effects for cocaine use

A 
Seizures and hallucinations
Pulmonary edema
Respiratory failure 
Cardiac problems
Maternal specific effects: first trimester spontaneous abortion, abruptio placenta, IUGR, preterm birth/and or still birth
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4
Q

Fetal effects for cocaine use

A 
Decreased birth weight and head circumference
Feeding difficulties 
Breast milk from cocaine mother
Extreme irritability 
Vomiting and diarrhea
Dilated pupils and apnea
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5
Q

Maternal effects for heroin use

A 
Poor nutrition and iron deficiency 
Preeclampsia-eclampsia 
Breech position
Abnormal placental implantation 
Premature rupture of membranes 
Preterm labor
Abruptio placenta
Meconium 
Higher incidence of STI and HIV
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6
Q

Fetal effects of heroin use

A

IUGR

Withdrawal symptoms after birth

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7
Q

Marijuana use

A

Difficult to evaluate

No known teratogenic effects

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8
Q

PCP use

A

Maternal overdose

Psychotic event

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9
Q

MDMA (ecstasy) use

A

Long term impaired memory and learning

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10
Q

Diabetes

A

Endocrine disorder of carbohydrate metabolism
Inadequate production of insulin
Inadequate utilization of insulin
Cellular or extra cellular dehydration (glucose in blood pulls water from cells)
Breakdown of fats and proteins (state of ketosis)

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11
Q

Gestational diabetes

A

Carbohydrate intolerance of variable severity

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12
Q

Causes of GDM

A

Unidentifiable preexisting disease
Effect of pregnancy on a compensated metabolic abnormality
A consequence of altered metabolic from change in hormone levels

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13
Q

Effects of pregnancy on carbohydrate metabolism

A

Early: increased insulin production and tissue sensitivity

Second half of pregnancy:
After 20 weeks
Increased peripheral resistance to insulin

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14
Q

Maternal risks with DM

A 
Hydramnios
Preeclampsia-eclampsia
Ketoacidosis 
Dystocia 
Increased susceptibility to infections
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15
Q

Fetal and newborn risks with DM

A 
Perinatal mortality 
Congenital anomalies 
Macrosomia
IUGR 
RDS
Polycythemia- abnormal increase in the number of RBC's in circulation 
Hyperbilirubemia
Hypoccemia
16
Q

Screening for DM

A

Low risk screens 24-28 weeks
High risk- early as feasible
One hour glucose tolerance testing <130-140 requires further testing
3- hour glucose tolerance testing GDM is diagnosed in 2 levels are exceeded

17
Q

Women at risk for GDM

A

Over 40
Family hx of diabetes in a first degree relative
Prior macrosomic, malformed, or sill born infant
Obesity
Hypertension
Glycosuria

18
Q

Treatment goals for GDM

A

Maintain a physiologic equilibrium of insulin availability and glucose
Utilization
Ensure an optimally healthy mother and newborn

Treatment: diet therapy and exercise
Glucose monitoring
Insulin therapy

19
Q

Fetal assessment in GDM

A 
AFP- to detect genetic abnormalities 
Fetal activity monitoring- kick counts 
NST
BPP-  HR acceleration, movement, tone, breathing movement, amniotic fluid volume 
Ultrasound
20
Q

Nursing management

A

Assess glucose level
Nutrition counseling
Education about disease process and management
Education about glucose monitoring and insulin administration
Assessment of the fetus
Support

21
Q

Maternal complications of iron deficiency anemia

A

Susceptible to infection
Tired easily
Increased change of preeclampsia and postpartum hemorrhage
Even minimal blood loss during birth not tolerated
Healing may be delayed

22
Q

Fetal comps from iron deficiency anemia

A 
Typically not iron deficient at birth but may develop during infancy
Low birth weight 
Prematurity
Stillbirth 
Neonatal death
23
Q

Treatment for iron deficiency anemia

A 
Prevention = 27 mg/iron/day
Tx= 60-120 mg/iron/day
24
Q

Folate deficiency

A

Sources: fresh leafy green vegetables, OJ, citrus fruits, red meats, poultry, fish, and legumes

25
Q

Maternal comps of folate deficiency

A

Nausea
Vomiting
Anorexia

26
Q

Fetal comps of folate deficiency

A

Neural tube defects

27
Q

Prevention and tx of folate deficiency

A

Prevention- 4 mg folic acid daily

Tx- 1 mg folic acid daily plus iron supplements

Nursing (1 decks)

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