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NUR 359: OB > Concurrent Disorders > Flashcards

Concurrent Disorders Flashcards

1
Q

women with hyperthryoidism usually suffer what for the first 4-8 weeks of pregnancy

A

severe N/V

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2
Q

how is hyperthyroidism treated in pregnancy

A

PTU

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3
Q

how long does it take for PTU to reach its max effectiveness for the tx of hyperthyroidism

A

6-8 weeks

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4
Q

women with hypothyroidism have a high risk of what?

A

infertility

rupture

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5
Q

how is hypothyroidism treated in preg

A

synthroid

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6
Q

what lab level is monitored with hypothyroidism?

A

TSH

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7
Q

what nursing education needs to be stressed to women who are preg w/ hypothyroidism?

A

timeliness of med admin

strict adherence to meds

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8
Q

what is maternal phenylketonuria?

A

a high accumulation of phenylalanine in the moms blood, and a deficiency of phenylalanine hydrolase (enzyme)

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9
Q

what can maternal PKU cause?

A

mental retardation, birth defects, and heart disease in babies

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10
Q

what is the key prevention for PKU?

A

ID of women in their reproductive years and babies when they are first born

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11
Q

if a woman has PKU, can they breastfeed?

A

no

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12
Q

if a baby has PKU, can they breastfeed

A

yes

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13
Q

name cardiovasc changes that occur during preg

A

incr intravasc vol
decr systemic vasc resistance
CO changes during labor and birth
intravasc vol changes that occur just after birth

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14
Q

how is CV disease classified?

A

class I-class IV

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15
Q

class I CV disease

A

asympt @ normal actvity level

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16
Q

class II CV disease

A

sympt w/ ordinary activity

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17
Q

class III disease

A

sympt w/ decr ordinary activity

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18
Q

class IV disease

A

sympt @ rest

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19
Q

when is CV disease classification evaluated in a preg?

A

3 months and again @ 7 or 8

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20
Q

women with CV diseases have a higher risk of what?

A 
miscarriages
preterm birth and labor
intrauterine growth restriction
congenital heart lesions incr in babies
decr CO to the baby
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21
Q

T/F- more and more heart transplant recipients are successfully completing pregnancies

A

True

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22
Q

if a woman is a heart transplant pt, what must they be assessed for before conception?

A
  • qual of ventricular fx

- potential rejection of transplant

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23
Q

what delivery method is preferred for heart transplant moms?

A

vaginal

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24
Q

what delivery method is more common among heart transplant recip moms

A

C sec

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25
Q

how long should conception be post-poned for after heart transplant?

A

at least 1 yr

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26
Q

infants of heart transplant mothers may exhibit what during the 1st week of life?

A

immunosuppressive effects

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27
Q

if a mother is a heart transplant, they cannot breastfeed if they are taking which med?

A

cyclosporine

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28
Q

what may happen during a vaginal delivery of a heart transplant recipient?

A
  • moms heart may have too much load
  • mom becomes very tired
  • HCP’s may have to use forceps or vaccuum to assist mom in labor
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29
Q

how does CPR in a pregnant woman differ from CPR in a reg pt?

A
  • defib paddles must be placed one rib interspace higher than usual
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30
Q

what should be monitored during and after cardiac arrest of mom?

A

fetus

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31
Q

what are ther objectives for mothers who have asthma?

A
  • relieve bronchospasm
  • limit irritant stimuli
  • decr pulm response to allergen exposure
  • limit inflammatory response in airways
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32
Q

what should be at the bedside or nearby of a mom with asthma regardless of when their last attack was?

A

inhaler

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33
Q

if an infant or mother has CF, they will be ______ of the CF gene?

A

carriers

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34
Q

what is an important characterization of CF?

A

exocrine glands produce and release excessive viscous secretions

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35
Q

how does CF complicate a pregnancy?

A
  • chronic hypoxia
  • frequent pulm infections
  • resp and digestive system problems
36
Q

what GI disorders may affect mom during preg?

A
  • cholelithiasis (gallstones)
  • cholecystitis (inflamm of the gallbladder)
  • IBD
37
Q

what birth defects are related to epileptic meds?

A

cleft lip/palate

neural tube defects

38
Q

what is a big concern/issue with epileptic moms?

A

failure to take medication

39
Q

why do epileptic moms fail to adhere to their RX regime during preg?

A
  • message that meds are harmful to the fetus

- risks to infants exxaggerated

40
Q

what is the concern if mom seizes while pregnant?

A
  • reduction of blood flow and O2 to the baby
41
Q

what can be done for moms with MS?

A
  • bed rest and steroids during exacerbations/ progression of the disease
42
Q

what is Lupus Erythematosus?

A

autoimmune antibody production that affects skin, joints, kidneys, lungs, CNS, and other body organs

43
Q

what is the concern for Lupus patients during preg?

A

immunosuppressive meds not reccommended during preg

44
Q

what is the objective for care of Lupus patients?

A

reducing the risk of infections

45
Q

what is super important for HIV + moms before conception (if possible)

A

preconception counseling

46
Q

when is a mom tested for HIV in her preg?

A

@ 8 weeks

47
Q

does pregnancy accelerate HIV/AIDS?

A

no

48
Q

how can HIV transmission to baby be reduced?

A

-if mom stays on meds throughout preg

49
Q

what groups are at an incr risk for HIV during preg?

A

-minority races and ethnicities

50
Q

what do HIV moms have an incr risk for?

A
  • concurrent infecs
  • std’s
  • sti’s
  • PID
51
Q

what factors affect how an HIV infected mother is treated?

A
  • patient
  • rship status
  • their behaviors
  • willingness to adhere to mgmt
52
Q

what HIV med must preg take?

A

Highly Active Antiretroviral Therapy (HAART)

53
Q

what else should HIV mothers be tested for?

A
  • sti’s

- hepatitis

54
Q

how should opportunistic infecs be treated in HIV mothers

A

meds specific to that infec

55
Q

what is the absolute objective of care for HIV pregnancy?

A

decreasing the neonates exposure to mom blood and secretions

56
Q

what medical precautions are taken during care of HIV preg?

A

standard precautions

57
Q

what risks are assoc with smoking moms?

A
  • bleeding complications
  • miscarriage/stillbirth
  • prematurity
  • placenta previa
  • placental abruption
  • low birth weight
  • SIDS
58
Q

what barriers stop sub abuse moms from getting prenatal tx

A
  • fear of losing custody of other kids or baby
  • criminal prosecution
  • sub abuse tx programs do not address issues affecting preg women
  • long waiting lists and lack of health insurance
59
Q

what is a realistic goal for treating sub abuse mom?

A

-decr sub abuse

60
Q

when are women more likely to make lifestyle changes

A

during a pregnancy

61
Q

T/F- there no meth tx for pregnant women

A

false- there is meth tx

62
Q

when are sub abuse moms difficult to care for?

A

intrapartum

PP

63
Q

are DM moms considered high risk?

A

yes

64
Q

what is the best approach to tx for DM moms?

A

multidisciplinary

65
Q

what is the key to optimum outcome for DM?

A

glucose control prior to and throughout preg

66
Q

what is the primary fuel used by the fetus?

A

glucose

67
Q

def Gest DM

A

any degree of glucose intol with onset or recognition during preg

68
Q

what is the rship bx hormones and insulin during preg?

A

placental hormones work in opposition to insulin

69
Q

important tx interventions of DM before preg?

A
  • importance of adhering to a plan
  • use of a dietary log
  • glucose control before preg
70
Q

what are serious risks/complications assoc w/ GDM?

A

ketoacidosis

hypoglycemia

71
Q

ketoacidosis is assoc w/

A

hyperglycemia

72
Q

when is a GDM mom at highest risk for hypoglycemia and why?

A
  • early in the pregnancy
  • hepatic production is diminished
  • insulin/meds may need to be tweaked
  • N/V
  • decreased food intake by mom
  • glucose transfer to embryo
73
Q

insulin needs during the first trimester and why

A
  • insulin needs reduced
  • incr insulin production by the pancreas
  • incr peripheral sens to insulin
74
Q

insulin needs during 2nd trimester

A
  • insulin needs incr

- placental hormones, cortisol, and insulinase act as insulin antagonists—> decr effectiveness of insulin

75
Q

insulin needs during 3rd trimester

A

-gradually incr until approx 36 weeks

76
Q

insulin needs on day of delivery

A
  • insulin needs drop drastically to pre-preg levels
77
Q

insulin needs of breastfeeding mothers

A

low insulin requirements

78
Q

insulin needs of non-breastfeeding mother

A

insulin needs of pre-preg level within 7-10 days

79
Q

insulin needs of mom who is weaning breastfeeding

A

insulin needs return to pre-preg levels

80
Q

def macrosomia

A

big baby at birth

81
Q

what is a macrosomic baby at risk for?

A

hypoglycemia

82
Q

babies of diabetic mothers are at incr risk for

A

-sudden/unexplained still birth
- congenital problems
CNS
Cardiac defects
skeletal defects

83
Q

diabetic mothers are at incr risk for what and what types?

A

-infections
UTI’s
yeast

84
Q

what birth complication are GDM patients at risk for

A

-shoulder dystocia

85
Q

what is the minimum glucose level of infants

A

40

86
Q

T/F- there is extensive diabetic tx needed PP for a GDM mom

A

fasle- no diabetic tx needed

NUR 359: OB (15 decks)

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