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Maternity > Exam 2 - Ch. 19 > Flashcards

Exam 2 - Ch. 19 Flashcards

1
Q

Does asthma symptoms increase or decrease with pregnancy?

A

Can do both.

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2
Q

Complications from asthma during pregnancy

A

Hemorrhage
Pulmonary embolism
Miscarriage

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3
Q

Dyspnea during pregnancy is normal or abnormal?

A

Normal

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4
Q

How is dyspnea during pregnancy different than asthma during pregnancy?

A

Asthma during pregnancy will present with wheezing and coughing.

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5
Q

A pregnant woman with asthma tells the nurse she stopped taking her meds because she didn’t want it to affect her baby. What is the best response?

A

Continue taking your asthma meds during pregnancy regardless of whether exacerbations occur.

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6
Q

Children of mothers with epilepsy are at increased or decreased chance of developing epilepsy?

A

Increased chance of developing epilepsy.

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7
Q

Complications of epilepsy during pregnancy include…

A

Preeclampsia
Preterm birth
Fetal death

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8
Q

What is the risk to the fetus for a pregnant woman who takes antiseizure meds?

A

Congenital anomalies, bleeding

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9
Q

What should a nurse include in education to a pregnant woman with epilepsy who is on meds to control it?

A

Continue taking the meds regardless of the risks and avoid seizure triggers.

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10
Q

What should the folic acid recommendation be for women with epilepsy?

A

Take 4 mg folic acid daily 3 months before conception.

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11
Q

What is the fetus at risk for when born to a mother with epilepsy who is taking anti-seizure meds?

A

Risk of bleeding, Congenital anomalies

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12
Q

Risks to pregnant mother with hypothyroidism …

A

Preeclampsia
Postpartum hemorrhage
Early pregnancy loss

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13
Q

How often should thyroid levels be checked in a pregnant woman?

A

Every 4 weeks to 3 months

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14
Q

What level is checked to establish thyroid levels in hypothyroidism in pregnant woman?

A

TSH

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15
Q

When are medication adjustments for hypothyroidism usually more adjusted during pregnancy?

A

Early in pregnancy

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16
Q

Hyperthyroidism in pregnant mother causes…

A

Maternal heart failure
Low birth weight
Pregnancy loss

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17
Q

Class of medications that cause thyroid suppression in hyperthyroidism in pregnant women?

A

Thioamides

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18
Q

What is the effect of thioamides on the fetus?

A

Cross the placenta
Suppress fetal thyroid hormone synthesis
Associated with fetal anomalies

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19
Q

Nursing education to pregnant mother with thyroid disorder

A

Medication compliance

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20
Q

What is the one goal of woman with pregestational diabetes who get pregnant?

A

Glycemic control

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21
Q

Pregestational diabetes complications…

A

Preeclampsia
Macrosomic fetus
Polyhydramnios
Fetal congenital anomalies
Spontaneous abortion
Perinatal death

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22
Q

Pregestational diabetes 1st trimester interventions (labs/screenings)

A

H1C
24-hr urine collection
Eye, Thyroid, Heart screenings

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23
Q

Pregestational diabetes 2nd trimester interventions

A

Vasculopathy may be evidenced by fetal growth restriction
Between 32-34 weeks:
nonstress test
biophysical profile
contraction stress test

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24
Q

Is vaginal delivery contraindicated in a pregnant woman with pregestational diabetes?

A

No, vaginal birth is not contraindicated

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25
Q

When would a c-section be advised for a pregnant woman with pregestational diabetes?

A

Macrosomia fetus diagnosed by ultrasound

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26
Q

At what time in gestation would a woman with pregestational diabetes be induced for a macrosomia fetus?

A

Between 39 and 40 weeks

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27
Q

Diet, exercise and medications are important considerations for what condition before pregnancy?

A

Pregestational diabetes

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28
Q

Which test, nonstress or contraction stress test, requires the pregnant woman to stimulate her nipples or administer oxytocin?

A

Contraction stress test

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29
Q

What is a reactive nonstress test in a fetus 32 weeks or older?

A

2 accelerations of 15 bpm for 15 sec each within 20 minutes.

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30
Q

What is a reactive nonstress test in a fetus younger than 32 weeks?

A

2 accelerations of 10 bpm for 10 sec each within 20 minutes.

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31
Q

How is a contraction test induced?

A

Use dilute oxytocin or have the woman stimulate her breasts until 3 contractions occur in 10 minutes.

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32
Q

What is a negative contraction test?

A

No late decels (placental insufficiency) or frequent variable decelerations (cord compression).

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33
Q

Recommendations to woman with diabetes who wants to get pregnant?

A

Achieve excellent glycemic control now.

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34
Q

What is a chronic immune-modulated dymyelinating disease of the CNS that includes relapses and remissions?

A

Multiple Sclerosis

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35
Q

When will a woman most likely experience remission of MS?

A

During pregnancy

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36
Q

When will a pregnant woman most likely experience a relapse of MS symptoms?

A

After birth (postpartum)

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37
Q

What risk factors are associated with MS in a pregnant woman and to the fetus?

A

Increased risk for cesarian birth and decrease in neonatal birth weight

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38
Q

Are medications for MS considered teratogenic?

A

Some are teratogenic. Others have limited info available.

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39
Q

Is breastfeeding contraindicated in women with MS?

A

No.

40
Q

Are medications for treating MS safe to take while breastfeeding?

A

They may not be.

41
Q

Can women with MS choose not to take their meds while breastfeeding?

A

Yes, they choose to not take their meds while breastfeeding.

42
Q

T/F: CVD is a significant cause of maternal morbidity and mortality in pregnancy?

A

True

43
Q

Cardiac output increases by what % during pregnancy that exacerbates cardiac conditions?

A

50%

44
Q

What tests exist to complete fetal testing of pregnant woman with CVD?

A

Nonstress, BPP, contraction test

45
Q

Signs of cardiac decompensation

A

Progressive edema (esp of face)
Cough
Crackles
Cyanosis (esp fingertips)
Tachypnea (>25 breaths/min)
Tachycardia (>125 bpm)

46
Q

What condition do these signs indicate?

Progressive edema (esp of face)
Cough
Crackles
Cyanosis (esp fingertips)
Tachypnea (>25 breaths/min)
Tachycardia (>125 bpm)

A

Cardiac decompensation

47
Q

What are the BP levels for chronic hypertension?

A

BP >140 over >90 before pregnancy or
before 20th month.

48
Q

What is mild to moderate high bp in a pregnant woman?

A

Mild to moderate hypertension is a systolic blood pressure between 140 and 159 mm Hg and/or a diastolic between 90 and 109 mm Hg

49
Q

What is severe hypertension in a pregnant woman?

A

> 160 mm Hg / > 110 mm Hg.

50
Q

Ranges for:
Mild hypertension
Moderate hypertension
Severe hypertension

A

Mild - BP >140 over >90
Moderate - Be/ 140 and 159 mm Hg and/or a diastolic be/ 90 and 109 mm Hg
Severe - > 160 mm Hg and diastolic blood pressure > 110 mm Hg.

51
Q

T/F: NSAIDS should be used to treat hypertension postpartum.

A

False, NSAIDs such as ibuprofen should be used cautiously for these patients postpartum as they are associated with increased blood pressure readings.

52
Q

T/F: NSAIDS should be used to treat hypertension postpartum.

A

False, NSAIDs such as ibuprofen should be used cautiously for these patients postpartum as they are associated with increased blood pressure readings.

53
Q

Intrauterine growth restriction, stillbirth, preeclampsia, and stroke are associated with what chronic condition?

A

Hypertension

54
Q

Hypertension is associated with what 4 conditions of pregnancy?

A

Intrauterine growth restriction, stillbirth, preeclampsia and stroke.

55
Q

No clear benefit of treating pregnant woman for what level of hypertension?

A

Mild to moderate (BP < 160 mm Hg and < 110 mm Hg.

56
Q

T/F: Fat has endocrine function

A

True

57
Q

T/F: Fat can have a detrimental effect on inflammatory pathways, vasculature, and metabolism.

A

True.

58
Q

What condition has the following complications?

Higher risk for gestational diabetes
Preeclampsia
Labor induction and induction failure
Slower first stage of labor
Macrosomic infants
Postpartum thromboembolism

A

Obesity

59
Q

Prepregnancy weight loss can do what?

A

Improve outcomes

60
Q

Is pregnancy challenging for a woman with eating disorder?

A

Yes

61
Q

Can women with an eating disorder who are not menstruating still get pregnant?

A

Yes

62
Q

What eating disorder is defined as follows:
- Restricted energy intake leading to significantly low body weight
- intense fear of weight gain
- Disturbed self-perception of one’s body, heavily influenced by weight
- Minimization of risk of low weight

A

Anorexia Nervosa

63
Q

What eating disorder is defined as follows:
- Recurrent binge eating with a feeling of loss of control
- Compensatory actions (vomiting, laxatives, extreme exercise)
- Self-perception heavily influenced by weight

A

Bulimia Nervosa

64
Q

What eating disorder is defined as follows:
- Binge eating with feeling of loss of control
- No compensatory actions

A

Binge Eating Disorder

65
Q

These are warning signs of what type of disorder:

History of eating disorder
Abnormally low body mass index
Lack of weight gain over two prenatal visits
Electrolyte abnormalities
Tooth enamel problems from vomiting
Hyperemesis gravidarum
Anxiety or mood disorder

A

Eating disorder

66
Q

Severe anemia leads to what conditions?

A

Nonreassuring fetal heart rate
Prematurity
Fetal loss
Maternal death

67
Q

T/F: Severe anemia is rare in developed countries.

A

True

68
Q

T/F: Physiologic anemia is an expected finding during pregnancy.

A

True

69
Q

A normal hemoglobin level in pregnancy is…

A

11 to 14 g/dL

70
Q

T/F: A hemoglobin level below 10.5 g/dL is considered diagnostic in pregnancy.

A

True

71
Q

What improves maternal hemoglobin and hematocrit levels?

A

Supplementing with iron

72
Q

Supplemental iron can cause what conditions?

A

Pruritus, rash, and gastrointestinal symptoms.

73
Q

How should iron be taken?

A

On an empty stomach but this can cause gastrointestinal distress.

74
Q

What is IPV?

A

Intimate partner violence

75
Q

At what points should pregnant women be screened for IPV?

A

Women should be screened for IPV during prenatal visits, hospitalizations, and during postpartum appointments.

76
Q

What tool is used in questioning women about IPV?

A

A standardized screening tool

77
Q

When should the nurse question someone about IPV?

A

When they are alone

78
Q

Infants exposed to opioids and opioid replacement drugs are at a high risk to undergo what syndrome at birth?

A

Neonatal abstinence syndrome.

79
Q

T/F: Alcohol is a teratogen

A

True

80
Q

What is the safe level of alcohol consumption during pregnancy?

A

There is no known safe amount of alcohol that can be consumed in pregnancy.

81
Q

Smoking can cause what conditions in pregnancy?

A

Preterm birth, intrauterine growth restriction, and stillbirth.

82
Q

Preterm birth, intrauterine growth restriction, and stillbirth occur with what substance abuse in pregnancy?

A

Smoking

83
Q

Outcomes from smoking and alcohol consumption in pregnancy can be improved by doing what?

A

Stopping consumption of alcohol or drugs at any point during pregnancy can improve outcomes.

84
Q

With which substance abuse are the following obstetric risks associated?
Subfertility
Pregnancy loss
Chorioamnionitis
Placental abruption
Preeclampsia
PROM
Preterm birth
Fetal growth restriction
Postpartum hemorrhage
Meconium-stained amniotic fluid

A

Opioid abuse

85
Q

With which substance abuse are the following risks associated?
Subfertility
Ectopic pregnancy
Pregnancy loss
PROM
Preterm birth
Preeclampsia
Decreased milk volume

A

Smoking

86
Q

With which substance abuse are the following risks associated?
Preterm birth
Low birth weight
Short for gestational age
Small for gestational age
Miscarriage
Placental abruption

A

Cocaine

87
Q

With which substance abuse are the following risks associated?
Fetal growth restriction
Gestational hypertension
Preeclampsia
Neonatal death
Fetal demise
Preterm birth

A

Methamphetamines

88
Q

Are antidepressants contraindicated in pregnancy?

A

No

89
Q

What do SSRIs cause in the neonate?

A

Possibly low APGAR scores

90
Q

What is depression in pregnant women usually treated with?

A

SSRIs

91
Q

Substance abuse, poor adherence to care, less prenatal care and suicidal tendencies are the result of what untreated condition in pregnancy?

A

Depression

92
Q

People with what condition report fatigue, tension, irritability, and a pervasive sense of apprehension?

A

Generalized anxiety disorder (GAD)

93
Q

GAD can be assessed with what scale?

A

A seven-item scale (GAD-7).

94
Q

Treatment for GAD includes…

A

Antidepressants (particularly SSRIs), counseling, and, occasionally, benzodiazepines.

95
Q

What conditions can benzodiazepines cause in pregnancy?

A

Withdrawal in the neonate
Preterm birth
Fetal loss

Maternity (8 decks)

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