Chapter 17 Flashcards
Acute illness
Disease or illness that is characterized by a sudden onset and limited duration
Chronic disease
Condition or illness that is characterized by long in some cases to find as greater than six months or permanent duration
Cognitive disability
Condition that involves impairment in intellectual activities such as thinking reasoning and remembering
Nosocomial infection
An infection inquired in a hospital or other healthcare facility that is usually caused by viruses, bacteria, or fungal pathogens
Physical disability
Physical condition that impairs, interferes with, or limits of persons ability to engage in certain task or actions or to participate in typical daily activities and interactions
Physical health
Refers to the conditions of the body or body systems, a continuum of health, lack of disease, or disability to states of acute or chronic illness, disability, or disease
Sensory disability
Condition that involves sensory organs, such as eyes, ears, or skin (touch)
Headaches and migraines
Migraine headaches especially related to menstruation may have a reduction in frequency and severity during pregnancy and lactation. Some evidence of lactational headaches associated with let down an over full breath. Common drugs that are compatible with breast-feeding include propranolol and nonsteroidal anti-inflammatory drugs.
Infectious diseases
Common cold and the flu are caused by viruses. They do not affect the ability to breast-feed. Parents should beware of decongestant containing pseudoephedrine because it can reduce milk production particularly in parents with poor or marginal milk. If antibiotics are needed for bacterial infection healthcare providers should use clinical guidelines for appropriate choices, dosing and duration of treatment.
Urinary track infection is the most common problem in women
Can be treated well with sulfamethoxazole and trimethoprim
Methicillin resistant staph infections (MRSA) is an antibiotic resistant infection they can either be hospital or community acquired
If a breast-feeding parent becomes infected breast-feeding and express milk should be withheld for 24 hours while antibiotic therapy is initiated. MRSA and other nosocomial infections in the newborn can be decreased by exposure to nontoxic bacterial flora via skin to skin contact after birth.
Group B streptococci (GBS) are leading cause of neonatal sepsis, is a common cause of neonatal morbidity and mortality
Treated with antibiotics it discovered prenative or intrapartum. If present in the vagina or rectal area can colonize the nasopharynx of the newborn during birth. Where can acquire GBS from breastmilk. Milk can be cultured and parent treated and continue breast-feeding
Tuberculosis
Not common and develop countries but very prevalent and developing countries. Parents who have tuberculosis at time of birth and appropriately treated with isoniazid can breast-feed. If tuberculosis is discovered at the time of birth it is necessary to separate the parent and infant for two weeks. Parent must initiate therapy and expressed milk to protect milk production. Issiazid is secreted into milk but levels are considered safe. Breast-feeding should be withheld for two hours after drug administration to avoid peak plasma concentrations
Zika virus spread by species of mosquitoes can be transmitted to the fetus during pregnancy and can cause congenital Zika fever with defects of the skull being the most common result
Human milk spread has not been confirmed although shedding of Zika virus material may be in the milk. Mothers who have suspected, probable, or confirm secret virus infection or travel to areas where Zika virus is endemic can breast-feed their infants.
Ebola virus characterized by fever, severe headache, muscle pain, weakness, fatigue, diarrhea, vomiting, abdominal pain, and unexplained hemorrhage.
Spread by close contact. Parents who are infected should not breast-feed. Decision about feeding the infant of a parent who is infected or has been infected must be weighed carefully. If there is no safe alternative to the parents milk the parent may have to breast-feed
HIV
HIV is classified as a retrovirus. Group of RNA viruses that insert a DNA copy of their genome into the host cell in order to replicate. When left untreated HIV infection results in the distraction of T cell immunity that allows recurrent, severe, and ultimately life-threatening opportunistic infections that manifest as aids. Spread by exchange of infected blood or by mucous membrane contact with infected blood and body fluids. In infants and small children most parent to child transmissions occur either pair of Natalie or through breast-feeding. HIV infected parents in high resource countries have been encouraged to avoid breast-feeding. Resource poor countries recommend exclusive breast-feeding for six months along with antiviral therapy for the mother and the baby. Perinatal HIV infection have dropped dramatically in the United States due to routine HIV screening in the use of a RT for the control and prevention of maternal infection, elective cesarean section and HIV positive women and avoidance of breast-feeding.
Asthma
In the US the prevalence of asthma among pregnant women is 3.7 to 8.7%. Exclusive breast feeding offers protection for infants and families with a history of asthma. Lactation should not be interrupted for asthmatic parents. Corticosteroids administered through metered dose inhaler‘s avoid systemic effects by delivery medication directly to the lungs. Bronchodilation are used to manage acute exacerbation’s.
Diabetes mellitus
Impaired carbohydrate metabolism is the Hallmark. Type one diabetes can occur pre-pregnancy in which insulin is not produced by the beta cells of the pancreas. Breast-feeding should be encouraged because colostrum helps to stabilize the Newports blood glucose. Parent and infant can experience local close levels after birth and must be monitored closely. Colostrum express prenatally can later referred to the hypoglycemic infant of a diabetic parent. If infant is admitted to neonatal intensive care milk expression should begin immediately. Insulin therapy is continued after giving birth. Insert it safe during lactation because it is such a large molecule. Delayed lactogenesis about one day may occur. Supportive practices such as early and continued skin to skin contact, rooming in, and feeding on cue can offset some of the factors. Diabetic parents may be at higher risk for mastitis and candiadiasis especially if they have elevated blood glucose levels.
Type two diabetes this is when there is impaired response to insulin and beta cell dysfunction
Can be part of the metabolic syndrome characterized by hypertension, obesity, dyslipidemia and polycystic ovary syndrome. It is much more common during pregnancy today due to higher obesity rate. Patients with type two diabetes are less likely to breast-feed. Metforman is often used to treat type two diabetes during and after pregnancy. Type two diabetes is associated with postpartum low milk production. May have a shorter duration of breast-feeding.
Gestational diabetes is a glucose intolerance that occurs during pregnancy. It occurs in an estimated 9% of all pregnancies in United States
Are less likely to breast-feed the non-diabetic counterparts. Breast-feeding should be encouraged because lactation improves the maternal metabolism of glucose and may prevent type two diabetes. Delayed lactogenesis can occur in parents with gestational diabetes which may be up to 1/3. Support is essential for parents as noted with type one and type two diabetes.
Thyroid disorders - Hypothyroidism
Hypothyroidism: thyroid function is imperative to maintaining A pregnancy. Symptoms include thyroid swelling or nodules, cold intolerance, dry skin, thinning hair, poor appetite, extreme fatigue and depression. Can result in low milk production. Thyroid supplementation is safe with breast-feeding. If diagnosed postnatal he will likely experience symptom release and increase milk production. If take thyroid supplements during pregnancy should be reevaluated in the postpartum. Because medication doses could likely be reduced to the pre-pregnancy level.
Hyper thyroidism
Occurs in the first postpartum year in 9% of women. Graves disease accounts from 95% of cases of hyperthy organism during pregnancy and only zero. 2% of cases post Natalie. Lactation is not usually impacted by hyperthyroidism. Anti-thyroid medication‘s are considered safe during lactation. However doses should be low to moderate because of concerns of hepatotoxic
Postpartum thyroiditis
Most common thyroid disorder. It affects 1.1 to 16.7% of women in the first year after birth. Believed to be an auto immune disorder. Includes fatigue, depression, and anxiety. May manifest is hyper thyroidism or hypo thyroidism or I can begin as hyperthyroidism and progressed to hypothyroidism. Need radioactive iodine uptake testing to actually make diagnosis which requires temporary breast-feeding interruption.
Pituitary dysfunction
Postpartum hemorrhage and hypotension can increase the pituitary gland to cease production of gonadotrophins leading to panhyppituitarism or Sheehan syndrome. Symptoms include lactation failure, loss of pubic and axillary hair, cold intolerance, breast and vaginal tissue atrophy, low blood pressure, secondary hypothyroidism, and adrenal failure. In severe cases the symptoms can occur and progress over the years.