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2ND YEAR 2ND SEM SUROB WITH PROBLEMS > MATERNAL PLACENTA PREVIA, HEART DISEASE, DM, ANEMIA > Flashcards

MATERNAL PLACENTA PREVIA, HEART DISEASE, DM, ANEMIA Flashcards

1
Q

What is placenta previa?

A

The placenta completely or partially covers the uterus (cervix) opening in the last months of pregnancy.

It is the most common bleeding disorder of the 3rd trimester.

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2
Q

What is the incidence rate of placenta previa?

A

1:200 pregnancies.

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3
Q

What happens to the placenta during early pregnancy?

A

It is common for the placenta to be low in the uterus.

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4
Q

What should happen to the placenta in the 3rd trimester?

A

The placenta should move to the top of the uterus.

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5
Q

What is the main complication of placenta previa?

A

The placenta blocks the baby’s exit from the vagina.

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6
Q

Name the types of placenta previa.

A
  • Marginal placenta previa
  • Partial placenta previa
  • Complete or total placenta previa
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7
Q

Describe marginal placenta previa.

A

The placenta is positioned at the edge of the cervix, touching it but not covering it.

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8
Q

What is a characteristic of partial placenta previa?

A

The placenta partially covers the cervix.

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9
Q

What is complete or total placenta previa?

A

The placenta is completely covering the cervix, blocking the vagina.

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10
Q

What are common signs and symptoms of placenta previa?

A
  • Sudden painless vaginal bleeding (begins 24-30 weeks)
  • Bright red bleeding (intermittent or in gushes)
  • Decrease in urinary output
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11
Q

What is the earliest and safest diagnostic tool for placenta previa?

A

Ultrasound.

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12
Q

Why is internal examination contraindicated in placenta previa?

A

It risks provoking life-threatening hemorrhage.

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13
Q

What are potential complications of placenta previa for the mother?

A
  • Bleeding
  • Anemia
  • Hypotension
  • Shortness of breath
  • Early birth
  • Placenta accreta
  • Placental abruption
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14
Q

What are the risks of premature birth for the baby due to placenta previa?

A
  • Low birth weight
  • Respiratory issues
  • Underdeveloped lungs due to premature birth
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15
Q

What is the goal of treatment for placenta previa?

A

To get the mother as close to the due date as possible.

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16
Q

What factors influence the treatment recommendations for placenta previa?

A
  • Severity of the bleeding
  • Gestational age of the baby
  • Position of the placenta and the baby
  • Health of the mother and the baby
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17
Q

Fill in the blank: If the placenta is near or covering just part of the cervix and no bleeding, the MD may recommend _______.

A

reducing strenuous activities, bed rest at home, no sexual intercourse, tampons, or douching.

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18
Q

What might be included in the management for moderate to severe cases of placenta previa?

A
  • Bed rest in the hospital
  • Medicine to prevent early labor
  • Steroids to help the baby’s lungs develop faster
  • Blood transfusion if heavy bleeding
  • Emergency C-section for heavy, uncontrolled bleeding
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19
Q

What is rheumatic heart disease (RHD)?

A

A complication of rheumatic fever in which the heart valves have been permanently damaged.

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20
Q

What can trigger rheumatic fever?

A

An infection with group A Streptococcus bacteria (such as strep throat or scarlet fever).

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21
Q

What are some potential complications of RHD during pregnancy?

A
  • Increased maternal and fetal risks due to increased blood pressure
  • Death of mother and baby
  • Increased risk of preterm delivery
  • Greater risk of heart failure before, during, or after delivery
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22
Q

What diagnostic test reveals cardiac changes in the mother?

A

Electrocardiogram (ECG)

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23
Q

What is echocardiography?

A

A test that uses sound waves to create a moving picture of the heart, providing information about disease etiology, severity, and monitoring progression.

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24
Q

What does a chest radiography (CXR) reveal in RHD?

A

Cardiomegaly (enlarged heart) / hepatomegaly.

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25
What does an ultrasound show in the context of RHD during pregnancy?
Fetal growth restriction.
26
Fill in the blank: Late deceleration on fetal monitor may occur if the mother's cardiac decompression caused _______.
placental incompetency.
27
What are the potential treatments for RHD?
* Hospital admission to treat heart failure * Antibiotics (Penicillin) for infection of the heart valves * Blood-thinning medications to prevent stroke * Heart valve surgery to repair or replace damaged heart valve.
28
What are some key patient outcomes for those with RHD?
* Maintain adequate cardiac output and placental perfusion * Maintain hemodynamic stability * Perform activities of daily living within the limitation of disease * Maintain adequate fluid balance * Maintain adequate ventilation * Give birth to a viable neonate.
29
What nursing interventions are important for a patient with RHD?
* Monitor fetal heart rate for changes * Assess maternal vital signs and cardiopulmonary status closely for changes * Reinforce the need for more frequent prenatal visits * Alert the patient to danger signs & symptoms that should be reported immediately.
30
True or False: RHD may not exhibit noticeable symptoms and is often undiagnosed until complications arise.
True
31
What dietary recommendations are suggested for patients with RHD?
* Limited sodium * Increased protein and iron intake.
32
What is the role of prophylactic antibiotics in RHD treatment?
To protect against infection, particularly during labor for women with mitral valve prolapse.
33
What is Diabetes Mellitus?
A group of metabolic disorders characterized by elevated levels of blood glucose (hyperglycemia) resulting from defects in insulin production and secretion, decreased cellular response to insulin, or both.
34
What percentage of diabetic patients are Type 1?
5% to 10%.
35
What causes Type 1 Diabetes Mellitus?
Destruction of beta cells of the pancreas by an autoimmune process.
36
What is the typical age of onset for Type 1 Diabetes?
Usually before the age of 30 years.
37
What type of treatment is required for Type 1 Diabetes?
Insulin injections.
38
What percentage of diabetics have Type 2 Diabetes?
About 90% to 95%.
39
What factors contribute to the development of Type 2 Diabetes?
Decreased sensitivity to insulin (insulin resistance) or decreased insulin production.
40
What is the typical age and characteristic of patients with Type 2 Diabetes?
Occurs most frequently in patients older than 30 years and obese.
41
How is Type 2 Diabetes initially treated?
With diet and exercise, then oral hypoglycemic agents as needed.
42
What defines Gestational Diabetes Mellitus?
Any degree of glucose intolerance with onset during pregnancy in clients not previously diagnosed as diabetic.
43
When should pregnant women be screened for glucose levels?
At the 26th week of gestation.
44
What is the usual treatment for Gestational Diabetes?
Frequently treated by diet alone, however, insulin may be needed for some clients.
45
What are some predisposing factors for Gestational Diabetes?
* Women 35 years of age or older * Younger than 25 years of age * Family history of diabetes in first-degree relatives * Obese * Certain ethnic-racial groups (e.g., African Americans, Native Americans)
46
What are common clinical manifestations of diabetes?
* Polyuria * Polydipsia * Polyphagia * Fatigue and weakness * Sudden vision changes * Tingling or numbness in hands or feet
47
What is the significance of a Fasting Blood Sugar (FBS) of 126 mg/dl or more?
It meets the threshold for the diagnosis of Diabetes Mellitus.
48
What is the normal blood glucose level range?
80 - 120 mg/dl.
49
What does a 3-hour glucose tolerance test confirm?
A diagnosis of Diabetes Mellitus if 2 out of 1 blood samples are abnormal or fasting blood value is above 95 mg/dl.
50
What does the Glycosylated Hemoglobin Measurement reflect?
The average blood glucose level over the past 4 to 6 weeks.
51
What is the normal range for HbA1c levels?
3.9% - 6.9% of the total hemoglobin.
52
How often should an ophthalmic examination be performed for diabetic patients during pregnancy?
Once per trimester.
53
What is the goal of therapy for managing diabetes during pregnancy?
To maintain blood glucose in a narrow low range of 65-130 mg/dl.
54
What should be monitored to manage diabetes in pregnant clients?
* Signs of hypoglycemia * Signs of hyperglycemia * Insulin needs * Blood glucose levels * Glycosuria and ketonuria
55
What dietary composition is recommended for diabetic patients?
* 50% to 60% carbohydrates * 12% to 20% protein * 20% to 30% fat
56
True or False: Oral hypoglycemic agents are used during pregnancy.
False.
57
What condition increases the risk for hypertensive disorders in pregnancy?
Gestational Diabetes Mellitus.
58
What complications can arise for newborns of diabetic mothers?
* Hypoglycemia * Hyperbilirubinemia * Respiratory distress syndrome * Congenital anomalies
59
What are the signs of preeclampsia to assess in pregnant diabetic patients?
* Hypertension * Proteinuria * Edema
60
What is the causative factor in the development of AIDS?
Human immunodeficiency virus (HIV) ## Footnote HIV causes a progressive and severe weakening of the immune system.
61
How does HIV affect the immune system?
It destroys T-helper lymphocytes, interfering with cell-mediated immunity ## Footnote This makes individuals highly susceptible to other infections and certain cancers.
62
What are the primary body fluids that can transmit HIV?
Blood, semen, breast milk ## Footnote Other fluids like urine, saliva, vomitus, and stool have lower concentrations of the virus.
63
True or False: HIV can cross the placental barrier.
True ## Footnote HIV can also cross the blood-brain barrier and vaginal mucosa.
64
List three ways HIV can be transmitted.
* Sexual contact * Transfusion with blood or blood products * Shared needles during drug use
65
What is a significant risk to mothers with HIV?
They are more vulnerable to postpartum infections ## Footnote They may experience symptoms such as fatigue, shortness of breath, nausea, and headaches.
66
What is the purpose of the Enzyme-Linked Immunosorbent Assay (ELISA) test?
It is a screening test for HIV antibodies ## Footnote ELISA is very sensitive but not highly specific.
67
Fill in the blank: The period it usually takes for a host to manufacture detectable HIV antibodies is _______.
6 to 12 weeks
68
What characterizes Stage 1 of AIDS?
Fever, myalgia, lymphadenopathy, headache
69
Describe Stage 3 of AIDS.
Symptomatic evidence of immune dysfunction affecting all body systems ## Footnote Common issues include integumentary and gynecological problems.
70
What is the treatment recommended for the prevention of maternal-fetal transmission of HIV?
Zidovudine (AZT) ## Footnote It is administered during pregnancy, labor, and to the newborn infant.
71
What nursing intervention should be taken during the prenatal period for HIV-positive mothers?
Instruct on good handwashing procedures ## Footnote Additional interventions include avoiding exposure to ill persons and certain foods.
72
What should be avoided during the intrapartal period to reduce HIV transmission risk?
Avoid episiotomy and administration of oxytocin ## Footnote These can increase the risk of maternal blood exposure to the neonate.
73
What should be done immediately after delivery to minimize HIV exposure to the neonate?
Promptly remove the neonate from the mother's blood and dry the infant
74
A condition that can develop as a result of iron deficiency with a hemoglobin below 10 g/dl or hematocrit below 30 g/dL.
Anemia
75
ntractable nausea and vomiting that persist beyond the 1st trimester and cause disturbances in nutrition, electrolytes and fluid balance.
Hyperemesis

2ND YEAR 2ND SEM SUROB WITH PROBLEMS (9 decks)

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