1229 Exam 4: Diabetic Mother Flashcards
Diabetes Mellitus
Decreased or zero insulin secretion
Gestational Diabetes
During Pregnancy
Goes Away after pregnancy
May not reoccur
May have BIG baby.
Type One Diabetes
no insulin produced most often before age 15 often called juvenile diabetes auto immune disorder causes disease life long disease
Type Two Diabetes
Insufficient insulin production ketoacidosis not common adults after forty most often occur may be called adult onset diabetes may need insulin
Mature Onset Diabetes of the Young
impaired insulin production
ketoacidosis not common
strong family history of type two
same characteristics as type two
Complications of insulin
hypoglycemia
lipodystrophy
somogyi effect
allergic reaction
Poorly controlled Diabetes
Diabetic Ketoacidosis (TYPE ONE)
hyperosmolar hyperglycemia
non ketotic coma (TYPE TWO)
fluid and electrolyte imbalance
Long term Complications
Angiopathy Peripheral Vascular Disease Retinopathy Nephropathy Neuropathy Infections
Assessment for both Type one and two
(THREE P'S) Polyphagia polydipsia polyuria fatigue increased UTI's
Type One Assessment
decreased weight
increased thirst
bed wetting
rapid onset
Type Two Assessment
increased weight
eye problems
slow onset
Treatment
Insulin Oral Hypoglycemics Diet decrease insulin need exercise decrease glucose fluctuation
Diagnostic Test
FBG > 126 mg/dl
comfirmed by repeat testing on another day or cusual or random glucose > 200mg/dl plus symptoms or glucose tolerance test > 200 mg/dl
Pathophysiology for Diabetes
cells within pancreas makes insulin
Type One
Type one– autoimmune attack pancreas, get energy from breakdown of muslces and fat.glucose is osmo-hyperosmo is vascular space. kidneys get rid of sugar and fluid in hyperglycemia too much potassium loss through cells into urine
Type Two
usually over weight, lifestyle factors, high fat diet, may or may not remain diagetes.
Most common races for GDM
hispanic
african american
(Caucasians have lowest rate.)
signs of diabetes
poly uria- dehydrated
trigger thirst
polydyspnea
polyfasia- increase in fluid and food intake
Long term damage
damage to small vessels in eyes
nerves in feet
kidney
macro-vascular changes
what should the laboring mother’s blood sugar be?
60-90
What does the A1C need to be?
5-6
signs of hypoglycemia
weak shaky clammy confusion cold and clammy need some candy
signs of hyperglycemia
flushed
warm
level of consciousness may change
nausea
GI problem
constipation
n/v
dehydration
acid reflux
What’s the main concern about Glucagon?
Aspiration. **Turn on pt side.
Postpartum Care
know that giving cows milk to babies too early will make their risk of diabetes go up.
BC pills could change glucose levels
weening baby
insulin requirements for mother go back up.
Test Monitoring
monitor mom with non stress test
biophysical profiles
watch for activity of fetus
when is blood sugar highest?
after you eat
Maternal and Fetal risk
pre conception counseling
spontaneous abortions
risk assessment for mom-blood sugar control (how long mother has had diabetes makes more of a risk of poor management)
DKA carries 20% mortality rate of the fetus
Gestational
Occurs later in pregnancy
Pregestational
had diabetes before pregnancy
