Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 3800 > Alterations In Antepartum > Flashcards

Alterations In Antepartum Flashcards

0
Q

Leading cause of death in US

A

Cardiovascular Disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Increased possibility of mom and/or fetus suffering harm, damage, loss, or death

A

High-risk pregnancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A chronic endocrine disorder of carbohydrate metabolism, results from inadequate production OR utilization of insulin/resistance to insulin

A

Diabetes Mellitus (DM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What will woman not be able to do if they have Diabetes Mellitus?

A

Women cannot meet need for essential nutrients for fuel and storage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is insulin produced by?

A

Beta cells of islets of Langerhans in pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does insulin lower glucose levels?

A

By enabling glucose to move from blood into muscle, liver, and adipose tissue cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where is glucose stored?

A

In liver as glycogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does glucagon do?

A

Stimulates breakdown of stored liver glycogen into glucose –> bloodstream
Also stimulates synthesis of glucose for amino acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Etiological classifications of DM

A

Type 1 DM
Type 2 DM
Impaired glucose tolerance/fasting glucose
Gestational DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Absolute insulin deficiency (due to autoimmune process); usually occurs before age of 30; appox 10% have this type

A

Type 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Insulin resistance or deficiency; primarily in adults over 30, but now being seen in children; 90% of diagnosed cases

A

Type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Glucose intolerance with its onset during pregnancy or first detected in pregnancy

A

Gestational diabetes Mellitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Classifications of DM in Pregnancy

A
  1. Pregestational diabetes (type 1 or 2)

2. Gestational diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What kind of complications could you see with a mother that has Pregestational Diabetes?

A

Retinopathy, nephropathy, neuropathy, CV disease, HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What risks come up with a mother with gestational diabetes

A

Risk of macrosomia, hypoglycemia, birth trauma, and mom in preeclampsia, C/S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Big babies often get _____ trauma at birth

A

Shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is macrosomia

A

Newborn with excessive birth weight. Fetus > 4,500 grams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is concern with gestational diabetes?

A

That it may progress to Type 2 DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

High blood glucose lead to what three things?

A

Cellular dehydration, glycosuria, extracellular dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are four classic symptoms of DM

A

Polyuria, polydipsia, polyphagia, weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Pathophysiology of DM

A

Pancreas doesn’t produce sufficient amounts of insulin, poor carbohydrate metabolism, glucose cannot move into cells it remains in bloodstream, body cells become energy depleted, fats and proteins are oxidized for energy, wasting of body’s fat and muscle tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What in cells is oxidized for energy in some one with DM

A

Fats and protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What can happen with wasting of body’s fat and muscle tissue in DM

A

Ketosis from fat breakdown and negative nitrogen balance with protein breakdown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does pregnancy affect Diabetes Mellitus

A
  • Physiologic changes alter insulin requirements

- may increase difficulty with DM control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What hormones affect DM? How?

A

Rise in progesterone, estrogen, Human Placental Lactogen, and Growth Hormone (somatotropin)
*they increase insulin resistance, especially the last 20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Insulin needs are _______ in the early 1st trimester. Why?

A

Decreased! hPL low, minimal embryo demands, less food consumed, N/V may occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

When do insulin requirements increase? When do they peak?

A

Increase late 1st trimesters and peak in last trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Why is insulin not sufficient especially in second trimester?

A

Placenta secretes hPL (antagonist), decidua produces prolactin, Growth Hormone, increased cortisol and glycogen
***so we see increased PVR to insulin and the process that makes insulin available to the fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is Hydramnios?

A

Excessive fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

PROM

A

Premature Rupture of Membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What does it mean if we say cord prolapse?

A

Umbilical cord falls through before baby and could cut off circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Complications for mom with DM

A

Hydramnios, Ketoacidosis, gestational HTN, hypoglycemia, preterm labor after PROM, stillbirth, chronic monilial vaginitis, difficult labor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Complications for fetus with DM

A

Cord prolapse with hydramnios, congenital abnormalities, macrosomia, birth trauma, preterm labor, fetal asphxia, perinatal death, polycythemia, RDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the 4 categories that can put a women at high risk for pregnancy

A

Pre-existing medical disorders
Social/personal
Obstetric/ previous pregnancy
CuRrent pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How many pregnant women have cardiovascular disorders

A

3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Although very few women die during pregnancy as result of heart disease what does happen

A

Experience other complications like HF, arrhythmias, stroke

36
Q

What kind of offspring does a women with cardiovascular disorders have

A

Premature, lbw, RDS, IVH, death

37
Q

Women with cardiovascular disorders ______ (can/cannot) have a successful pregnancy

A

Can

38
Q

What conditions need to avoid pregnancies

A

Tetralogy of fallot
Transposition of great vessels
Eisenmengers syndrome

39
Q

Why is pregnancy hard for women with cardiovascular disorders

A

Normal adaptions that pregnant women make are harder to make for their heart

40
Q

What kind of adaptations that most pregnant women have to make are hard for women with cardiovascular disorders to make

A

Increased workload
Increased blood volume
Increased cardiac output

41
Q

Class I cardiovascular disorder

A

Uncompromised

A symptomatic

42
Q

Class II cardiovascular disorder

A

Slightly compromised

Some fatigue, palpitation, anginal pain

43
Q

Symptoms of abortion

A

Pelvic/abdominal cramping
Bleeding
Passage of products of conception

44
Q

What are two meds you would give to a person having an abortion

A

Rhogam

Anything to produce uterine contractions

45
Q

How is an ectopic pregnancy formed

A

Implantation of fertilized ovum outside uterus

46
Q

Where is the most common site for an ectopic pregnancy

A

Fallopian tube

47
Q

There are multiple causes for an ectopic pregnancy one being a drug called diethylstilbestrol (DES) what is this drug used for

A

Was used for nausea

Women whose mothers were given this drug while pregnant are more susceptible to have an ectopic pregnancy

48
Q

What are symptoms of and ectopic pregnancy

A 
One-sided abdominal pain
No menses until 1-2 months
Internal and external bleeding
Referred right shoulder pain 
Hcg increases slowly
49
Q

What must you do for a ruptured ectopic pregnancy

A

Medical emergency& pregnancy loss

50
Q

Gestational trophoblast disease

A

Hydatidiform mole- benign neoplasm of chorion

51
Q

Common sign for hydatidiform mole

A

Vaginal bleeding

Often brownish but sometimes bright red

52
Q

What are the two types of gestational trophoblastic disease

A

Complete and partial

53
Q

Complete gestational trophoblastic disease

A

Develops from “empty” egg being fertilized with normal sperm

54
Q

What is the risk with complete gestational trophoblastic disease

A

Choriocarcinoma

55
Q

Partial gestational trophoblastic disease

A

Normal ovum fertilized by 2 sperms or 1 sperm without chromosome 46

56
Q

Symptoms of gestational trophoblastic disease

A

Vaginal bleeding
Anemia
Hydrops vesicles
Rapid enlargement of abdomen

57
Q

What is one thing that elevated hcg’s could mean

A

Choriocarcinoma

58
Q

Why must you treat choriocarcinima immediately

A

Could metastasize to lung, lower genital tract, brain, and liver

59
Q

Class III cardiovascular disorders

A

Markedly compromised
Excessive fatigue, dyspnea, palpitation, anginal pain
Comfortable at rest

60
Q

Class IV cardiovascular disorders

A

Severely compromised
Cannot do physical activities w/o anginal pain
Symptomatic at rest

61
Q

What class of cardiovascular disorders should avoid pregnancy

A

Class IV

62
Q

How is a pregnant women with cardiovascular disorder have different doctor visits than normal

A

More assessments

Every 2 weeks until 36 weeks and then every week until birth

63
Q

What are factors that could cause strain on a pregnNt women with cardiovascular disorders

A

Infection
Anemia
Pyelonephritis
Weight gain

64
Q

What are our goals of nursing care with a pregnant women with a cardiovascular disorder

A

Early diagnosis

Stabilization of maternal hemodynamic status

65
Q

What are 4 ways as nurses we can help a pregnant women with cardiovascular disorders.

A

More frequent visits
Educate her to increase understanding
Decrease anxiety and stress
Talk to support systems

66
Q

What are some nutritious foods to tell a women with cardiovascular disorders to keep in mind

A 
Iron
Protein
Low sodium
Adequate calcium 
High fiber
67
Q

If you see in a clients chart that she is having testing done soon what should you do

A

Prepare them for it and warn them and tell them all the good that it will do for the baby and the pregnant mother

68
Q

Is the nursing care for a pregnant women with cardiovascular disorder over when she delivers

A

No

Post-partal care is just as important as antepartal

69
Q

a condition that results in an increased level of circulating red blood cells in the bloodstream

A

Polycythemia

70
Q

What could be wrong if your infant is showing symptoms of irritability and occasional tetany?

A

Hypocalcemia

71
Q

Immature liver cannot metabolize increased bilirubin resulting from polycythemia

A

Hybilirubinemia

72
Q

Care goals DM patient

A

Minimize risks of disease to achieve healthy mom and newborn, maintain glycemic control, nutritional management, exercise

73
Q

What is medication of choice in pregnancy and lactation

A

Insulin

74
Q

Goal for Pregestational DM fasting glucose

A

Equal to or less than 126 mg/dL

75
Q

Goal for gestational DM @ 24-28 weeks fasting glucose

A

Less than 92 mg/dL

76
Q

What is good control for Glycosylated hemoglobin HbA1c level?

A

Less than 7%

77
Q

Measurement of average glucose levels during past 100-120 days

A

Glycosylated hemoglobin HbA1c level

78
Q

What does a high HbA1c level correlate with? Greater than what level?

A

Correlates with fetal congenital anomalies. Greater than 10% correlates with 20-25% anomalies

79
Q

What type go insulins don’t cross placenta?

A

Short acting like lispro (Humalog) and aspart (NovoLog). Oral hypoglycemics like metformin and glyburide

80
Q

What can you use to evaluate fetal status with DM

A

Alpha fetoprotein, fetal movement, NST, biophysical profile in nonreactive NST, Ultrasound, amniocentesis

81
Q

What would you do if mother with DM had nonreactive NST?

A

Biophysical profile

82
Q

Normal L/S ratio? What would you see with diabetic?

A

2/1

Would see higher with diabetic

83
Q

What would you do to get L/S ratio in DM patient? What do you want it to be ?

A

Amniocentesis for L/S ratio (2-3.5). Want it to be higher to deliver the baby

84
Q

How should you store insulin

A

Cool temperature

85
Q

What may insulin needs do following delivery

A

Decrease because fetus no longer there and hormones change

86
Q

What should you teach postpartum mom about sexual activity

A

Use barrier methods for BC. Don’t want her to get pregnant and don’t want her to take BC

87
Q

Why do insulin needs fall postpartally

A

Fall in hPL, progesterone, and estrogen levels

NURS 3800 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions