Test 4 Medical Surgical Disorders Flashcards
(49 cards)
What are hemodynamic changes of pregnancy?
- CO increases 30-50% by mid-pregnancy
- Placental fluids back into vascular system after birth
CV changes during pregancy constitute a major complication for the client with ____ ____ ____.
preexisting heart disease
What is cardiac decompensation?
inability to maintain adequate cardiac output
What are the NYHA classifications r/t Functional Ability? (Mom with CV problems are rated this way)
Class I
Class II
Class III
Class IV
Which class? Asymptomatic, no limitations of activity
Class I
Which class? Symptomatic with slight limitation of activity
Class II
Which class? Symptomatic, marked limitation, normal activity leads to cardiac symptoms
Class III
risk for MI, may need c-sec
Which class? Cardiac insufficiency or angina occurs even at rest.
Class IV (poor fetal perfusion, c-sec b/c mom can't handle the stress of vaginal delivery)
The greatest risk for CV issues is ___-___. Why?
28-32
That’s when the mom’s volume peaks
Can the NYHA classification change for mom during pregnancy?
Yes, it is not absolute
What are the 3 major cardiac concerns during pregnancy?
1) cardiac decompensation
2) CHF
3) circulatory changes lead to decreased uterine perfusion
Decreased uterine perfusion can lead to…
- spontaneous abortion
- preterm labor and birth
- IUGR
Symptoms of CHF:
1) Edema (progresses from pedal edema to generalized, pitting, and pulmonary edema)
2) Fatigue increasing
3) Dyspnea with ADL
4) Crackles at bases of lungs
What do you monitor in a pt with CV issues?
Vitals
Symptoms of decompensation
Symptoms of infections
Why do we worry about infection in a CV pt?
Infection increases the workload of the heart
What diagnostic tests are often used on a CV pt?
EKG
Echo
Cardiac cath
Fetal status (serial testing - baby gets checked multiple times a day)
When is a prophylactic antibiotic given to mom? Why?
- invasive procedures
- at birth
(to prevent bacterial endocarditis)
What drug can be given to mom to increase contractility of the heart and slow heart for effective filling?
Lanoxin
What meds are commonly given to moms with CV probs?
- prophylactic antibiotic
- lanoxin
- antiarrhythmic
- diuretic (controversial)
- heparin
FDA categories for drugs
A: no risk
B: harm not confirmed
C: only if benefits justifies the potential risk to fetus
D: fetal risk, but benefits may out weigh the risk
X: never give to pregnant woman
4 reasons for anemia during pregnancy?
- iron deficiency
- folate deficiency
- sickle cell trait
- sickle cell disease
An autosomal recessive genetic disorder that results in mild obstructive lung disease.
cystic fibrosis
What can severe cystic fibrosis result in?
maternal & perinatal mortality
What is a risk for the fetus with CF?
uteroplacental insufficiency –> IUGR
