Class 6 Study Guide Flashcards
1
Q
Hyperemeisis Gravidarum is associated with-
A
- loss of 5% or more of prepregnancy weight
- dehydration
- acidosis from starvation
- elevated blood and urine ketones
- alkalosis from loss of hydrochloric acid in gastric fluids
- hypokalemia
2
Q
Hyperemesis Gravidarum s/s
A
- elevated hct and hgb due to dehydration
- low sodium,potassium and chloride
- high creat due to renal dysfunction
3
Q
Hyperemesis Gravidarum etiology
A
- unmarried white women
- first pregnancy
- multifetal pregnancy
- elevated hormones
- H. pylori
4
Q
When does gestational HTN appear
A
-after 20 weeks of pregnancy that isn’t accompanied by proteinuria
5
Q
When does preeclampsia appear
A
-after 20 weeks of pregnancy with proteinura
6
Q
Preeclampsia patho
A
- result of generalized vasopasm
- blood volume increases, CO increases and BP remains the same, but PVR decreases normally
- in preeclampsia, PVR increases instead of decrease
- this causes reduced diameter of blood vessels, impeded blood flow, elevated blood pressure,circulation decreases
- decreased renal perfusion reduced GFR and causes glomerule damage (protein excretion), fluid shift (hypovolemia and edema), epigastric pain(liver involvement), small cerebral hemorrhages (blurred vision, see spots, hyperreflexia), pulmonary edema (deyspnea), and decreased placental circulation (IUGR, fetal hypoxemia)
7
Q
Home management for preeclampsia
A
- if mild and stable:
- activity restriction
- monitor fetal activity
- monitor bp multiple times a day
- weight each morning
- UA
- good diet
8
Q
Antepartum management in hospital for preeclampsia
A
If severe:
- multisystem involvement
- bed rest
- quiet environment
- anticonvulsant meds (mag sulfate)
- antihypertensives
9
Q
Intrapartum management for preeclampsia
A
- most seizures occur during labor and PP
- lateral position
- analgesics
- induced if deterioration
- vaginal birth
- oxytocin and mag sulfate with continued EFM (decreased variability due to mag sulfate)
10
Q
Postpartum Management for preeclampsia
A
- assess EBl and shock
- continuefor48 hours
- S/S of recovery: 4-6 L/day, decreased protein in urine, lab improvement, bp WNL in 2 weeks
11
Q
4 priority assessments for Mag Sulfate
A
- respiration >12
- O2 sat >95
- presence of DTR
- U/O >30mL/hr
- (clonus)
12
Q
Magnesium Sulfate Toxicity
A
- respiratory depression
- absent DTRs
- sweating
- flushing
- confusion
- lethargy
- slurring of speach
- drowsiness
- disorientation
- hypotension
- D/C mag, notify physician
- have calcium gluconate readily available for antidote
13
Q
Coombs test done at ______ and give Rhogam within _____ of birth
A
- 28 weeks
- 72 hours
14
Q
Classification of DM
- Type 1
- Type 2
- Gestational
A
Type 1: -insulin dependance -autoimmune of beta cells -prone to ketosis Type 2: -diet controlled or insulin dependent -insulin resistance -ketosis less likely Gestational: -onset first diagnosed with pregnancy -GDM A1 diet control GDM A2 insulin control with diet
15
Q
Pre existing DM during first trimester fetal risk
A
- increase risk of spontaneous abortion and fetal complications
- congenital malformations: neural tube defects, cardiac
