Diabetes & PP depression Flashcards
Postpartum blues is characterized by
tearfulness, anxiety, irritation, and restlessness occurring about 3 days after childbirth and usually fading within 10 days
WHy would baby blues occur right after birth?
There is a big hormonal shift after placenta comes ouh
Postpartum depression lasts
more than 14 days following birth with worsening symptoms
Diagnosis of postpartum depression
symptoms persist more than 2 weeks; a depressed mood or lack of interest in pleasurable activities much of the day, almost every day
What are some of the remaining symptoms that must be present
depressed mood, agitation, fatigue, poor concentration and decision making, poor appetite, insomnia, feelings of failure, guilt, unusual worry over infant’s head
What are some treatment methods for PP depression?
sleep, nutrition, exercise, social support system, counseling with a therapist
Medication treatment for PP depression?
Selective Serotonin Reuptake Inhibitors (SSRI); initiate half usual starting dose
How long do you treat PP depression?
for at least 6 months after remission to prevent relapse
Postpartum psychosis is a
psychiatric emergency due to risk of suicide and fetal harm
What is postpartum onset like?
very sudden and occurs in the first 4 weeks postpartum
Who is more at risk for postpartum psychosis?
people with a history of bipolar
Signs and symptoms of PP psychosis
bizzrre behavior, disorganization of thought, hallucinations, delusions, irritation, hyperactive, decreased need for sleep
What is the key to optimum pregnancy outcome?
strict maternal glucose control
Almost all women with pregestational diabetes are
insulin dependent
How do you diagnosis gestational diabetes?
screening @ 24-26 weeks gestation with 50g oral glucose, and a 3 hour OFTT-Fasting (1hr, 2hr, 3hr)
Fetal risks of gestational diabetes?
congenital malformations, RDS, extreme prematurity, IURD
How often is a patient with diabetes seen?
Every 1-2 weeks until 36 weeks gestation and then weekly after
What determines a macrosomia baby?
greater than 9 pounds
Why does a mother with gestational diabetes lead to a bigger baby?
The insulin causes the body to store the excess glucose as fat which makes the baby grow larger than normal
What does the excess glucose in the abby do?
cause the pancreas to produce insulin
What do you do anytime there is vomiting?
Check glucose
What do you test the urine for in a woman with diabetes?
ketones
What are flags to macrosomic infants (especially in multigravida woman)
slow descent and long labor
How many RN’s is needed to initiate the McRoberts Maneuver?
Two
Why would they deliver in a delivery room opposed to a birthing room?
There is more room and equipment for newborn resuscitation
IDM
A baby who lived up to 40 weeks in a hyperglycemic state and is cut of supply of glucose when cord is cut
How does an infant respond to being cut off from glucose?
Hypoglycemia
Nursing actions of hypoglycemic infant
heel sticks for glucose levels, if less then 40 immediately, feed formula
