ATI: Medical Conditions Flashcards
An US shows a short cervix, presence of funneling, or effacement of the cervical os indicates what?
Cervical insufficiency
What prophylactic action can HCP do for clients w/ cervical insufficiency?
Cervical cerclage which helps prevent premature cervical dilation
A woman w/ cervical insufficiency is discharged home. What can she do to promote a soft uterus vs. a contracting uterus?
Increase hydration because dehydration causes uterine contractions
When can cervical cerclage be applied to a woman who has cervical insufficiency?
12-14 weeks
When is a cervical cerclage removed?
Between 37 and 38 weeks
What are the risks for hyperemesis gravidarum for the fetus
- Intrauterine growth restriction
- SGA
- Preterm (if condition persists)
Why is urinalysis the most important lab test to obtain in women w/ hyperemesis gravidarum?
Because it tests for ketones and acetones (breakdown of protein and fats)
Why is metabolic alkalosis a finding in women with hyperemesis gravidarum?
D/t excessive vomiting
What can we excpect with lab values for hematocrit (Hct) in women w/ hyperemesis gravidarum?
- elevated d/t hemoconcentration (all fluid is leaving)
What do women w/ hyperemesis gravidarum get to replinish hydration?
Lactated ringers
What vitamin/supplement can we give women w/ hyperemesis gravidarum?
pyridoxine (vitamin B12)
Name the progression of diet advancement in women w/ hyperemesis gravidarum
- Clear liquids
- Crackers, dry toast, cereal (bland)
- Soft diet
- Normal diet
Pica is due to what insufficiency?
Iron
What levels of Hgb will indicate iron-deficiency anemia in a pregnant woman during 1st and 3rd trimesters?
Less than 11
What levels of Hgb will indicate iron-deficiency anemia in a pregnant woman during 2nd trimester?
Less than 10.5
What levels of Hct levels will indicate iron-deficiency anemia in a pregnant woman?
Less than 33%
What levels of blood ferritin will indicate iron-deficiency anemia in a pregnant woman?
Less than 12
What is the recommended iron intake for a pregnant woman?
37/mg day
Most prenatal vitamins typically have 30mg
What medication can we give a woman w/ iron deficiency anemia?
Ferrous sulfate
Pt. educaiton for ferrous sulfate?
- Take on empty stomach
- Take w/ orange juice
- Increase roughage and fluids to help w/ constipation
What is the expected blood glucose level (in a pregnant woman) during fasting?
60-99
What is the expected blood glucose level (in a pregnant woman) 2hrs after meals?
Less than 120
What is a positive 1 hour blood glucose test?
What values?
130-140
What if we have a positive 1 hour test?
We do a 3 hour test
Is fasting needed for the 3 hour glucose test?
If so, how many hours?
Yes, fasting is needed 12 hours before the 3 hour glucose test
What other substances need to be avoided before doing a 3 hour glucose test?
- Caffeine
- Smoking
What is the first form of treatment for women w/ gestational diabetes?
Exercise and diet
What is the second form of treatment for women w/ gestational diabetes?
Medications
ATI did not really talk about it, but glyburide may be used
What are the criteria to classify a gesteraionl hypertension diagnosis?
- Onset of hypertension after 20 weeks gestation
- BP reading of 140/90
- Reading must be 2 seperate times, 4 hours apart
- No proteinuria
What is the criteria for preeclampsia?
- Gestational hypertension
- WITH proteinuria of greater or equal to 1+
Edema and headaches can be present as well
What do we see in severe preeclampsia?
Proteinuria 3+
Ankle clonus
BP 160/110 or greater
Severe headache
Blurred vision
Creatinine 1.1 or more
Oliguria
Extensive peripheral edema
Hyperreflexia
Epigastric or RUQ pain
Thrombocytopenia (low number of platelets in the blood)
What distinguishes eclampsia vs preeclampsia?
Eclmapsia we see seizure activities
We see headaches, epigstric pain, RUQ, hyperrflexia
What is HELLP?
- H:hemolysis; anemia & jaundice
- EL: Elevated liver enzymes; high ALT/AST, epigastric pain, n/v
- LP: Low platelets; less than 100,000; thrombocytopenia, bleeding gums, peteichae and possible DIC
What is the best way to mantain a regular flow rate of magnesium sulfate?
Use an infusion control device
What first needs to be done if you notice magnesium sulfate toxicity?
Stop infusion!
What is the antidote for magensium sulfate?
Calcium gluconate
What are som s/s of magnesium sulfate toxicity?
- Depressed resp. rate
- Absent deep tendon reflexes
- Urine output less than 30ml
- Decreased LOC
- Cardiac dysrhythmias
