Medical Conditions Affecting Pregnancy Outcomes (Pregestational Conditions)

Question 1

Responsible for the 5% of death during pregnancy

Answer 1

Cardiovascular Conditions

Question 2

Damage in the heart’s valve/valves, aorta or pacemakers

Answer 2

Cardiovascular Conditions

Question 3

The most dangerous time for Cardiovascular conditions:

Answer 3

28 to 32 weeks

Question 4

Cardiovascular Conditions

Answer 4

• Congenital heart anomaly (ASD, uncorrected coarctation
  of the aorta)
• Rheumatic heart disease
• Kawasaki disease
• Marfan syndrome
• Left-sided Heart Failure
• Right-sided Heart Failure

Question 5

No symptoms of cardiac insufficiency and no angina pain with ordinary activity.

Answer 5

Class I: uncompromised

Question 6

Ordinary activities causes excessive fatigue, palpitation, dyspnea, or angina pain.

Answer 6

Class II. Slightly compromised

Question 7

Cardiac system is most compromised during the first 48 hrs after delivery

Answer 7

Class II. Slightly compromised

Question 8

Implication of Class II. Slightly compromised

Answer 8

Patient can experience normal pregnancy and birth.

Question 9

Implication of Class III. Markedly compromised

Answer 9

Patient can complete pregnancy through complete bedrest. To facilitate delivery, the physician will use forceps.

Question 10

Implication of Class IV. Severely compromised

Answer 10

Patient is poor candidate of pregnancy because of cardiac failure. But a woman with a pacemaker implant can also expect to complete the pregnancy.

Question 11

No limitation of physical activity

Answer 11

Class 1

Question 12

Ordinary physical acitivity does not cause symptoms

Answer 12

Class 1

Question 13

Slight limitation of physical activity

Answer 13

Class II

Question 14

comfortable at rest, ordinary physical activity causes symptoms

Answer 14

Class II

Question 15

marked limitation of physical activity

Answer 15

Class III

Question 16

comfortable at rest, but less than ordinary activity causes symptoms

Answer 16

Class III

Question 17

severe limitation and discomfort with any physical activity

Answer 17

Class IV

Question 18

symptoms present even at rest

Answer 18

Class IV

Question 19

NURSING ASSESSMENT for Cardiovascular Conditions

Answer 19

F- atigue
R- ales
E- dema of face
E- dema of extremities

P- alpitations; P- ulmonary edema
H- eart murmors; hemoptysis,
O- rthopnea (discomfort on breathing
which is relieved by sitting or standing.
N- eck vein distention
E- dema of eyelids

C- ardiomegaly; crackles at base of lungs
D- yspnea (SOB)

Question 20

MATERNAL AND FETAL EFFECTS of Cardiovascular Conditions

Answer 20

▶ Fetus may die during labor because fetus may receive inadequate oxygen and blood supply.
▶ Intrauterine growth retardation (IUGR)
▶ Miscarriage
▶ Anemia on the mother
▶ Preterm labor and birth
▶ Maternal cardiac decompensation, including myocardial failure and cardiomyopathy
▶ Severe fetal distress due to poor tissue perfusion or inadequate blood flow for carbon dioxide exchange.

Question 21

DIAGNOSTIC TESTS for Cardiovascular Conditions

Answer 21

A- uscultation of heart sounds
C- hest X-Ray
C- ardiac catheterization
E- lectrocardiogram
E- chocardiogram

Question 22

In Medical Management of Cardiovascular Conditions, Hospitalization for __________ before delivery

Answer 22

1- 4 weeks

Question 23

In Medical Management of Cardiovascular Conditions, IV antibiotics __________ if not allergic to prevent congenital bacterial endocarditis.(eg. _______________________________________________)

Answer 23

Penicillin; AMPICILLIN, AMOXICILLIN, CLINDAMYCIN

Question 24

____________ if she develops coagulation problem

Answer 24

Heparin

Question 25

to treat congestive heart failure

Answer 25

Thiazide diuretics

Question 26

In Nursing Management of Cardiovascular Conditions, Teach woman to lie in lateral position to increase _______________________ and to level legs while sitting to promote _______________.

Answer 26

utero placental blood flow; venous return

Question 27

Assessment of DVT

Answer 27

PAIN AND REDNESS IN THE CALF (+)PULMONARY EMBOLISM

Question 28

TREATMENT of DVT

Answer 28

* BED REST * IV OR SUBCUTANEOUS HEPARIN (LMWH) * ASPIRIN

Question 29

is a metabolic disorder characterized by hyperglycemia (elevated serum glucose level) resulting from lack of insulin, lack of insulin effect or both.

Answer 29

Diabetes Mellitus

Question 30

NORMAL BLOOD SUGAR LEVELS=

Answer 30

80 to 120 mg/dL

Question 31

A high blood sugar (glucose) that develops during pregnancy and usually disappears after giving birth.

Answer 31

Gestational Diabetes

Question 32

Gestational Diabetes can happen at any stage of pregnancy, but is more common in the

Answer 32

second or third trimester

Question 33

It happens when your body cannot produce enough insulin – a hormone that helps control blood sugar levels – to meet your extra needs in pregnancy.

Answer 33

Gestational Diabetes

Question 34

3Ps SIGNS OF HYPERGLYCEMIA

Answer 34

Polyuria Polydipsia Polyphagia

Question 35

Excessive excretion of urine): osmotic diuresis occurs caused by the glucose high osmotic pressure within renal tubules.

Answer 35

Polyuria

Question 36

(excessive thirst): results from extra/intracellular fluid dehydration

Answer 36

Polydipsia

Question 37

(excessive eating): results from starvation of cells.

Answer 37

Polyphagia

Question 38

a 1 hour glucose test. 50 gm oral glucose load is used at 24-28 weeks gestation to detect early gestational DM during the first prenatal visit. No fasting or preparation is needed.

Answer 38

Oral Glucose Challenge Test (OGCT)

Question 39

onfirms gestational DM

Answer 39

Oral Glucose Tolerance Test

Question 40

deliver a dose of insulin without a needle to make a tiny hole . This is a force through the skin with pressure.

Answer 40

Insulin jet injectors

Question 41

The inability to meet major roles, an increase in legal problems, or risk taking behavior, or exposure to hazardous situation.

Answer 41

Substance Use Disorder

Question 42

Substances

Answer 42

1.Cocaine 2.Amphetamines 3.Marijuana/Cannabis 4.Heroin

Question 43

COCCAINE -FROM A PLANT

Answer 43

ERYTHROXYLUM COCA

Question 44

Neurostimulant and neurotoxin

Answer 44

AMPHETAMINES

Question 45

Vasocontrictive decreasing blood flow to maternal heart, brain, and uterus.

Answer 45

AMPHETAMINES

Question 46

People who use develop blackened and infected teeth

Answer 46

AMPHETAMINES

Question 47

Crosses the placenta and has the effect of increasing carbon monoxide levels in the mother’s blood, reducing oxygen supply to the fetus.

Answer 47

CANNABIS AND HASHISH

Question 48

occurs when an Rh-negative mother (one negative for a Dantigen or one with a dd genotype) carries a fetus with an Rh-positive blood type.

Answer 48

Rh incompatibility

Question 49

Therefore, most of the maternal antibodies formed against the Rhpositive blood are not formed during pregnancy but in the _______________ after birth, making them a threat to a _____________ pregnancy.

Answer 49

first72 hours; second

Question 50

All women with Rh-negative blood should have an ___________________ done at a first pregnancy visit.

Answer 50

anti-D antibody titer

Question 51

a commercial preparation of passive Rh (D) antibodies against the Rh factor, is administered to women who are Rh-negative at 28 weeks of pregnancy

Answer 51

Rh (D) immune globulin (RhIG)

Question 52

s given again by injection to the mother in the first 72 hours after birth of an Rh-positive child to further prevent the woman from forming natural antibodies.

Answer 52

RhoGAM (RhIG)

Question 53

If it is Rh-positive— Coombs’ negative, indicating that a large number of antibodies are not present in the mother—the mother will receive the _________injection

Answer 53

RhIG

Question 54

Types of Anemia

Answer 54

❑ Iron Deficiency Anemia ❑ Folic Acid Deficiency

Question 55

Inadequate levels of Hgb in the blood < 12 gms/dl

Answer 55

ANEMIA

Question 56

The most common medical complication of pregnancy

Answer 56

Iron Deficiency Anemia

Question 57

lesions of corner of the mouth

Answer 57

C-heilosis