Ch 20 Selected Health Conditions and Vulnerable Populations Flashcards
when do pregnant women get screened for diabetes and what do we look for in that screening
first prenatal visit
- urine in protein, ketones, nitrates, HbA1c, alpha-prtien levels in fetus, amniocentesis
what blood sugar is considered standard on the glucose challeneg test
less than 140 mg/dL
if the mother ends up using medicine for her diabetes, when is it suggested that she deliver
39 weeks
is there an increase or decrease in blood volume during pregnancy
blood volume increases the first few weeks of pregnancy and continues to rise from there. 40-45% total increase
increase or decrease in heart rate during pregnancy
normal for moms heart rate to increase by 10-20 bpm
increase or decrease in cardiac output during pregnancy
by 28-34 weeks the mom’s CO might increase by 30-50%c this is because of the higher blood volume and faster heart rate
what is the leading cause of serious complications and death during pregnancy
cardiomyopathy
4 risk factors for CVD-related maternal mortality
race, older than 40, hypertension/preeclampsia, and obesity
hypertension before pregnancy is diagnosed by which week
before the 20th week of gestation
gestational hypertension blood pressure paramteters
over 140/90 that begins after 20 week of pregnancy
preeclampsia is also considered a hypertension diagnosis but
it also presents with protein in the urine
what is Thalassemia
inherited blood disorder that causes the body to have less hemoglobin than normal
side effects of thalassemia on patient
can cause anemia, leaving the patient feeling fatigued/ and or short of breath
alpha- less severe
beta- usually dont have a long life and pregnancy will not be fulfilled
does cytomegalovirus pass to the baby in utero
yes
what is cytomegalovirus
herpes virus that is the most common congenital and perinatal viralinfection
what is rubella
infection that affectsthe skin and lymph nodes
- aka german measles or 3-day measles
complications of rubella during pregnany
an infected infant during pregnancy can continue to shed the virus for about a year
Herpes Simplex Virus
- examples
genital herpes, cold sores,
how do babies get herpes simplex virus
passing through vaginal canal
from being kissed orhaving contact with someone who has herpes mouth sores
If a mom has Hepatitis B (HBV) during pregnancy what will you do for the baby
Receive a birth dose of Hep B vaccine within 24 hrs of delivery
Then 3-4 additional shots at 1-2 months of age
How can you treat HepB during pregnancy
antiviral therapy with tenofovir or telbivudine starting at 28-32 weeks of gestation
Varicella zoster virus (aka chicken pox) effects during pregnancy on mom and baby
maternal mortality, congenital abnormalities, fetal varicella syndrome
how does Parvovirus B19 spread to the baby
through placenta and umbilical cord= can cause severe anemia in baby which can be treated with an intrauterine infusion
GBS (group b strep) infection during pregnancy can lead to
preterm labor, stillbirth, premature rupture of membrane
mom comes into hospital to givebirth and test positive for group b strep, what do you do
antibiotics work best given at least 4 hours before delivery and 90% of infections are prevented with this type of treatment
Toxoplasmosis
disease caused by parasite getting into the body by mouth (usually from undercooked meat)
can moms with HBV breastfeed
yes, its not a contraindication to not breastfeed unless the woman is taking antiviral medications or has bleeding nipples since this is spread by infected blood
drug therapy regiment for a mom with HIV
The standard treatment is oral antiretroviral drugs given daily until giving birth, IV administration during labor, and oral zidovudine (AZT) for the newborn within 6 to 12 hours of birth
what is the best birth method for women with HIV
cesarean birth performed before the onset of labor and before the rupture of membranes significantly reduces the rate of perinatal transmission at 38 weeks
risk factors of being a pregnant woman over 35
infertility and spontaneous abortions, gestational diabetes, chronic hypertension, postpartum hemorrhage, preeclampsia, preterm labor and birth, multiple pregnancy, genetic disorders and chromosomal abnormalities, placenta previa, fetal growth restriction, low Apgar scores, and surgical births
what lab test do woman who are pregnant over 35 usually get
Amniocentesis is routinely offered to all older women to allow the early detection of numerous chromosomal abnormalities, including Down syndrome. Additionally, a quadruple blood test screen (AFP, human chorionic gonadotropin [hCG], unconjugated estriol [UE], and inhibin A [placental hormone]) drawn between 15 and 20 weeks of pregnancy can be helpful in screening for Down syndrome and neural tube defects.
obese pregnant woman are at risk for
Gestational diabetes
Hypertension
Thromboembolism
Preeclampsia
Preterm labor and birth
Congenital anomalies
Childhood and adolescent obesity
Fetal macrosomia (birth weight over 4,000 g)
Difficulty fighting postpartum infections
Depression
Tendency to remain overweight/obese between pregnancies
Prolongation of pregnancy/increased likelihood of post-term infant
Increased risk of stillbirth
Low birth weight
Higher rate of cesarean births
Early pregnancy loss
Increased risk of maternal mortality
High risk for postpartum hemorrhage (
effect of alcohol in pregnancy
Spontaneous abortion, inadequate weight gain, IUGR, FASD (the leading cause of intellectual disability)
effect of caffeine in pregnancy
Vasoconstriction and mild diuresis in mother; fetal stimulation, but teratogenic effects not documented via research
what is a teratogenic effect
will cause birth defects
nicotine effect during pregnancy
Vasoconstriction, reduced uteroplacental blood flow, decreased birth weight, abortion, prematurity, placental abruption, fetal demise
cocaine vs marijuana effect on pregnancy
cocaine:Vasoconstriction, gestational hypertension, placental abruption, abortion, central nervous system defects, IUGR
marijuana:Anemia, inadequate weight gain, “amotivational syndrome,” hyperactive startle reflex, newborn tremors, prematurity, IUGR
opiates and narcotic effect on pregnancy
Maternal and fetal withdrawal, placental abruption, preterm labor, premature rupture of membranes, perinatal asphyxia, newborn sepsis and death, intellectual impairment, malnutrition
typical characteristics of newborn with fetal alcohol syndrome
low nasal bridge, thin upper lip, epicanthal folds, minor ear abnormalities
A pregnanct client has cytomegalovirus. What can this cause in the newborn
Mirocephaly seizures iugr
