CHAP 20 - 109 Flashcards
HOW MANY CLASSES DOES A PREGNANT PT WITH CARDIAC DISEASE
4 CLASSES
CLASS I
Uncompromised. Ordinary physical activity causes no discomfort. No symptoms of cardiac insufficiency and no anginal pain.
CLASS II
Slightly compromised. Ordinary physical activity causes excessive fatigue, palppitation, and dyspneaor anginal
pain.
Markedly compromised. During less-than-ordinary activity, patient experiences excessive fatigue, palpitations,dyspnea, or anginal pain.
CLASS III
Severly compromised. Patient is unable to carry out any physical activity without experiencing discomfort. Evenat rest, symptoms of cardiac insufficiency or anginal pain are present.
CLASS IV
ASSESSING A PREGANT PT WITH DM
Confusion, if hyperglycemic
Dizziness, if hypoglycemic
Thirst
Increased risk of pregnancy induced hypertension
Congenital anomalies
Macrosomia
Poor fetal heart tone variability and rate from poor tissue perfusion
Hydramnios
Possibility of increased monilial infection
Hyperglycemia
ASSESSING A VENOUS THROMBOEMBOLIC DISEASE
(PIIPT)
Pulmonary embolus may occur
Increased estrogen level causes increased blood coagulation
Increased blood congestion in pelvis leads to stasis
Poor vebous return from pressure of uterus leads to stasis
Thrombophlebitis may occur
ASSESSING A PREGNANT PT WITH CARDIAC DISEASE
(FCITDPE)
Fatigue
Cough
Increased respiratory rate
Tachycardia
Decreased amniotic fluid from intrauterine growth restriction
Poor fetal heart tone (FHT) variability from poor tissue perfusion
Edema from poor venous return
- the incidence of venous thromboembolic disease increases during pregnancy because of a combination of stasis of bloodinthelower etremities from uterine pressure and hypoagulability.
VENOUS THROMBOEMBOLIC DISEASE
relating to or caused by an embolus, which is a blockage in a blood vessel, often a traveling blood clot.
EMBOLIC
- a combining form meaning “blood clot”, “coagulation”, or “thrombin”, used in medical terms to describe conditions related to blood clots and clotting processes.
THROMBO
ASSESSING A PREGNANT PT WITH RENAL DISEASE
Elevated blood pressure from poor kidney function
Flank pain, if pyelonephritis is present
Proteinuria in urine; frequency and burning on urination and bacteriuria if UTI is present
Elevated serum creatinine from decreased kidney function
Edema from inability of kidneys to evacuate fluid
CLASSIFICATION OF DM
TYPE I
TYPE II
GESTATIONAL DIABETES
IMPAIRED GLUCOSE HOMEOSTASIS
Risk Factors for Developing Gestational Diabetes include:
Obesity
Age over 25 years
Hx of large babies (10 lb or more)
Hx of unexplained fetal or perinatal loss
Hx of congenital anomalies in previous pregnancies
Hx of polycystic ovary syndrome
Family Hx of diabetes (one close relative or two distants ones)
Member of a population with a high risk of diabetes
A condition of abnormal glucose metabolism that arises duting pregnancy. Possible signal of an increased risk for type 2 diabetes later in life.
GESTATIONAL DIABETES
A state characterized by the destruction of the beta cells in the pancreasthatusually leads to absolute insulin deficiency
a. Immune-mediated diabetes mellitus results from autoimmune destruction of the beta cells. b. Idiopathic type 1 refers to forms that have no known cause
TYPE I DM
FASTING
95
Oral Glucose Challenge Test Values (Fasting Plasma Glucose Values) for Pregnancy Following a 100-G Glucose Solution
Oral Glucose Challenge Test Values (Fasting Plasma Glucose Values) for Pregnancy Following a 100-G Glucose Solution
A state that usually aries because of insulin resistance combined witharelativedeficiency in the production of insulin.
TYPE II DM
1 HR
180
A state between “normal” and “diabetes” in which the body is no longer usingorsecreting insulin properly. a. Impaired fasting glucose: a state when fasting plasma glucose is at least 110butunder 126 mg/dL. b. Impared glucose tolerance: a state when results of the oral glucosetolerancetest are at least 140 but under 200 mg/dL in the 1-hour sample.
IMPAIRED GLUCOSE HOMEOSTASIS
2 HRS
155
3 HRS
140
results from autoimmune destruction of beta cells
IMMUNE-MEDIATED DM
forms that have no known cause
IDIOPATHIC TYPE 1
