Ch 20 Selected Health Conditions and Vulnerable Populations

Question 1

when do pregnant women get screened for diabetes and what do we look for in that screening

Answer 1

first prenatal visit
- urine in protein, ketones, nitrates, HbA1c, alpha-prtien levels in fetus, amniocentesis

Question 2

what blood sugar is considered standard on the glucose challeneg test

Answer 2

less than 140 mg/dL

Question 3

if the mother ends up using medicine for her diabetes, when is it suggested that she deliver

Answer 3

39 weeks

Question 4

is there an increase or decrease in blood volume during pregnancy

Answer 4

blood volume increases the first few weeks of pregnancy and continues to rise from there. 40-45% total increase

Question 5

increase or decrease in heart rate during pregnancy

Answer 5

normal for moms heart rate to increase by 10-20 bpm

Question 6

increase or decrease in cardiac output during pregnancy

Answer 6

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

Question 7

what is the leading cause of serious complications and death during pregnancy

Answer 7

cardiomyopathy

Question 8

4 risk factors for CVD-related maternal mortality

Answer 8

race, older than 40, hypertension/preeclampsia, and obesity

Question 9

hypertension before pregnancy is diagnosed by which week

Answer 9

before the 20th week of gestation

Question 10

gestational hypertension blood pressure paramteters

Answer 10

over 140/90 that begins after 20 week of pregnancy

Question 11

preeclampsia is also considered a hypertension diagnosis but

Answer 11

it also presents with protein in the urine

Question 12

what is Thalassemia

Answer 12

inherited blood disorder that causes the body to have less hemoglobin than normal

Question 13

side effects of thalassemia on patient

Answer 13

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

Question 14

does cytomegalovirus pass to the baby in utero

Answer 14

yes

Question 15

what is cytomegalovirus

Answer 15

herpes virus that is the most common congenital and perinatal viralinfection

Question 16

what is rubella

Answer 16

infection that affectsthe skin and lymph nodes
- aka german measles or 3-day measles

Question 17

complications of rubella during pregnany

Answer 17

an infected infant during pregnancy can continue to shed the virus for about a year

Question 18

Herpes Simplex Virus
- examples

Answer 18

genital herpes, cold sores,

Question 19

how do babies get herpes simplex virus

Answer 19

passing through vaginal canal
from being kissed orhaving contact with someone who has herpes mouth sores

Question 20

If a mom has Hepatitis B (HBV) during pregnancy what will you do for the baby

Answer 20

Receive a birth dose of Hep B vaccine within 24 hrs of delivery
Then 3-4 additional shots at 1-2 months of age

Question 21

How can you treat HepB during pregnancy

Answer 21

antiviral therapy with tenofovir or telbivudine starting at 28-32 weeks of gestation

Question 22

Varicella zoster virus (aka chicken pox) effects during pregnancy on mom and baby

Answer 22

maternal mortality, congenital abnormalities, fetal varicella syndrome

Question 23

how does Parvovirus B19 spread to the baby

Answer 23

through placenta and umbilical cord= can cause severe anemia in baby which can be treated with an intrauterine infusion

Question 24

GBS (group b strep) infection during pregnancy can lead to

Answer 24

preterm labor, stillbirth, premature rupture of membrane

Question 25

mom comes into hospital to givebirth and test positive for group b strep, what do you do

Answer 25

antibiotics work best given at least 4 hours before delivery and 90% of infections are prevented with this type of treatment

Question 26

Toxoplasmosis

Answer 26

disease caused by parasite getting into the body by mouth (usually from undercooked meat)

Question 27

can moms with HBV breastfeed

Answer 27

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

Question 28

drug therapy regiment for a mom with HIV

Answer 28

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

Question 29

what is the best birth method for women with HIV

Answer 29

cesarean birth performed before the onset of labor and before the rupture of membranes significantly reduces the rate of perinatal transmission at 38 weeks

Question 30

risk factors of being a pregnant woman over 35

Answer 30

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

Question 31

what lab test do woman who are pregnant over 35 usually get

Answer 31

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.

Question 32

obese pregnant woman are at risk for

Answer 32

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 (

Question 33

effect of alcohol in pregnancy

Answer 33

Spontaneous abortion, inadequate weight gain, IUGR, FASD (the leading cause of intellectual disability)

Question 34

effect of caffeine in pregnancy

Answer 34

Vasoconstriction and mild diuresis in mother; fetal stimulation, but teratogenic effects not documented via research

Question 35

what is a teratogenic effect

Answer 35

will cause birth defects

Question 36

nicotine effect during pregnancy

Answer 36

Vasoconstriction, reduced uteroplacental blood flow, decreased birth weight, abortion, prematurity, placental abruption, fetal demise

Question 37

cocaine vs marijuana effect on pregnancy

Answer 37

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

Question 38

opiates and narcotic effect on pregnancy

Answer 38

Maternal and fetal withdrawal, placental abruption, preterm labor, premature rupture of membranes, perinatal asphyxia, newborn sepsis and death, intellectual impairment, malnutrition

Question 39

typical characteristics of newborn with fetal alcohol syndrome

Answer 39

low nasal bridge, thin upper lip, epicanthal folds, minor ear abnormalities

Question 40

A pregnanct client has cytomegalovirus. What can this cause in the newborn

Answer 40

Mirocephaly seizures iugr