gestational diabetes

Question 1

what is pregnanacy induced hypertenison

Answer 1

hypertension that happens when pregnant

potentially severe and even fatal elevation of blood pressure that occurs during pregnancy

Question 2

PIH symptoms

Answer 2

-rapid weight gain
-swelling of face and fingers (some edema in ankles is normal for pregnancy)
-flashes of light or dots before eyes
-diminess or blurriness in vision
-severe continous headache
-decreased urine output
-proetienuria
Weight gain over 2lb/week in the second trimester, 1 lb/week in the 3rd trimester

Question 3

PIH -gestational hypertension

Answer 3

greater than 30 above systolic and 15 above diastolic
no proteinuria
no edema

Question 4

mild pre-eclampsia

Answer 4

greater than 30 above systolic 15 above diastolic of pre-preganancy BP

• proteinuira 1+-2+ in random urine sample
• edema yes
• weight gain of 2 lbs or more in the second trimester and 1 lb per week in the third

Question 5

severe pre-eclampsia

Answer 5

greater than 160 systolic or above 30 diastolic of pre-pregnancy bp
-3+-4+ proetienuria
extreme edema
severe epigastric pain and nausea or vomiting

Question 6

eclampsia

Answer 6

greater than 160 systolic or above 30 diastolic of pre-pregnancy bp (same as sever pre-eclampsia)

• 3+-4+ proetienuria
• cerebral edema
• may include grand mal seizure or coma, baby is at risk

Question 7

pharmacology for preganancy induced hypertension

Answer 7

• labetolol

- magnesium sulfate

Question 8

nursing care for mild-pre-eclampsia

Answer 8

promote bed rest, good nutrition, emotional support, education

Question 9

nursing care for severe pre-eclampsia

Answer 9

hospitalized, bed rest, darkened room, monitor bp Q4 hr (or continous monitor), monitor HCT, daily weights, accurate intake and output, high protein diet, monitor fetal well

Question 10

what is gestational diabetes mellitus

Answer 10

a condition of abnormal glucose metabolism that arises during pregnancy, 3-5% of all pregnancys

Question 11

risk factors for gestational diabetes

Answer 11

• age greater than 25
• family history of diabetes
• race
• Previous medical history (congenital abnormalities in pregnancy, polycystic ovary syndrome, unexplained fetal loss-later in pregnancy)
• obesity
• history of larger babies (greater than 10 pounds or 4.5kg)

Question 12

Prevention of GDM

Answer 12

• eat healthy foods
• loose any extra weight prior to pregnancy
• exercise before and during pregnancy
• maternal vitamins and supplements (onset 3 months prior to conception)
• regular check ups and screeing for: glucose tolerance test, proteinuria, HTN, HgA1Cm UTI
• glycemic control for diabetic mother: type 1 or type 2

Question 13

Diagnosing GDM, suggested screening tests for GDM:

Answer 13

all pregnant women between 24-28 wks gestation
glucose challenge
glucose tolerance test
HGA1C

Question 14

interventions for GDM

Answer 14

• self moinitoring of blood glucose: glycemic control is essential, if receiving insulin-nocturnal hypoglycemia is at increased risk
• presence of ketones in blood/urine: monitors dietary intake is adequate, ketones can cause acidosis- fetal anoxia
• nutrition therapy/dieticain: proper weight gain, nutriton and meal planning, adeuqate protein and calcium intake
• Physical actvity: typically encouraged, may have special OB restrictions for bed rest

Question 15

complications for MOM with GDM

Answer 15

• retinopathy
• hypertenison
• chronic kidney disease (CKD)
• CVD

Question 16

complications for baby when mom has GDM

Answer 16

Hyperglycemia, has adverse effects on the fetus throughout pregnancy: at conception and during first trimester

• increases the risk of multiple fetal malformations
• later in pregnancy, it increase the risk of macrosomia and metabloic complications at birth

Question 17

what is macrosomia

Answer 17

mothers blood brings extra glucose to the fetus
fetus makes more insulin to handle extra glucose
extra glucose gets stored as fat and fetus becomes larger than normal

Question 18

Pharmological interventions when to add with GDM

Answer 18

if not reaching glycemic targets within 2 weeks of glucose tolerance test with nutrition alone add pharmacological interventions -initiate insulin therapy

Question 19

baby may be hypoglycemic right after birth so

Answer 19

put to mothers breast immediately

Question 20

what is the only type of medication you give to mothers with GDM

Answer 20

insulin only

Question 21

pharmacological interventions for GDM

Answer 21

insulin:
-humalog (short-acting)-sliding scale 
-insulin pump (1 unit/1 hr) 
-insulin infusion while during labour
-continoulsy monitor for signs of hyperglycemia/hypo
ALSO ASSES FETAL GROWTH VIA ULTRASOUND