Ch. 20

Question 1

When is insulin production highest in the maternal body?

Answer 1

1st trimester

Question 2

Elevated Estrogen and Progesterone levels in the 1st trimester will cause BG to do what?

Answer 2

BG will fall

Question 3

What weeks will BG be the lowest?

Answer 3

13-20 weeks

Question 4

What is a mother prone to with type 1 diabetes?

Answer 4

DKA diabetic ketoacidosis

Question 5

Why is 13-20 weeks prone to hypoglycemia?

Answer 5

Placenta not developed, No glucogenesis yet, Insulinase develops with placenta

Question 6

First trimester insulin needs

Answer 6

Lowered because of pancreas overproduction, and increased peripheral sensitivity

Question 7

Second trimester insulin needs

Answer 7

increase because of hormones, cortisol and insulinase decreasing the effectiveness of insulin

Question 8

Thrird Trimester insulin needs

Answer 8

Double or Quadruple, but level off at 36 weeks

Question 9

Fetal side effects of type 2 diabetic mother

Answer 9

LGA, Poor lung maturity, Need teaching on diet and exercise

Question 10

Best fetal outcome for a mother with diabetes

Answer 10

strict control on BG

Question 11

How to diagnose a mother with GDM

Answer 11

At 28 weeks, 1 hr GTT with 50g, if BG is above 130 then 3 hr GTT with 100g. 2 positives = confirmation

Question 12

Most common endocrine disorder

Answer 12

Diabetes

Question 13

Three P’s of diabetes

Answer 13

Polydipsia, Polyphagia, Polyuria

Question 14

Newborn is having BG problems after birth, why?

Answer 14

Pancreas is making much more insulin because of sugar from mom. Baby will become hypoglycemic

Question 15

Complications with lupus during pregnancy

Answer 15

HTN, PTL, miscarriage. All relate to clotting

Question 16

What medication would a pregnant woman with lupus receive

Answer 16

Lovenox (Low molecular weight heparin) - anticoagulant

Question 17

Four P’s of drug abuse

Answer 17

Parents, Partner, Past, Pregnancy

Question 18

Drug abuse - Parents

Answer 18

Parents of mother might have drug abuse problems

Question 19

Drug abuse - Partner

Answer 19

Partner of mother might have drug and alcohol abuse problems

Question 20

Drug abuse - Past

Answer 20

Has the mother had drug/alcohol problems in the past?

Question 21

Drug abuse - Pregnancy

Answer 21

Was the mother an abuser before her pregnancy, and has she abused during the pregnancy

Question 22

Sx of heroine withdrawal

Answer 22

SGA infant, decreased moro reflexes hypothermia or hyperthermia