module 13 pregnancy care Flashcards
common complaints
fatigue
feeling hot
HEENT complaints
- visual change: contact irritation
- sinus congestion
Breast and vaginal complaints
- vaginal discharge
- decreased libido
- nipple discharge
- braxton-hicks
Respiratory complaints
dyspnea
Vascular complaints
nose bleeds
bleeding gums
varicosities/spider veins
headaches
Musculoskeletal complaints
low back pain
GI complaints
gagging heartburn/GERD N/V Gas Constipation hemorrhoids
integumentary changes
cholasma acne stretch marks linea negra change in nail and hair growth
Labeling rule Rx
Pregnancy: includes labor and delivery
Lactation: includes nursing mothers
Females and males of reproductive potential
Anemia s/s, inc. risk of
s/s - fatigue - dizzy - pica - dyspnea - tachycardia - palpitations Inc. risk - preterm labor - low birth wt - infant mortality
UTI care, inc. risk of
inc. risk of
- premature delivery
- low birth wt
Care
- urine cx at 12-16 wk to check for asymptomatic bacteriuria
– tx: colony counts > 100,000
Group B strep
approx. 25% of preg women Universal screening at 35-37 wks Risk of passing to baby at delivery - sepsis - pneumonia - meningitis Tx with abx during labor
women with previous GBS
should be tx with abx during delivery, no need to test between 35-37 weeks.
pre gestational DM risk to fetus
vary greatly depending on control of sugars in 1st trimester.
Uncontrolled
- fetal malformations
–anencephaly, microcephaly
– congenital heart disease
– major birth defect directly proportional to degree of blood sugar control
risk factors for GDM
Latino Asian Pacific Islander Native American obesity sedentary lifestyle family hx previous hx of GDM deliver of a macrosomic infant PCOS insulin resistance hx CV disease
GDM risk to fetus
macrosomia neonatal hypoglylcemia hyperbilirubinemia shoulder dystocia stillbirth
maternal complications of GDM
preeclampsia
C-section
inc. risk of developing DM later in life
hypothyroidism
overt: high TSH, low T4
subclinical: high TSH, nml T4
associated with fetal risk of
- anemia
- neuro-cognitive deficits
- gestational HTN
- low birth wt
- miscarriage
- placental abruption
- preeclampsia
- preterm birth
high risk for thyroid disease
personal or family hx T1DM automimmune disorder hx of pregnancy loss infertility hx preterm delivery morbid obestiy 2 or more previous preg. older than 30
thyroid labs
on levothyroxine
- TSH every 4-6wks until 20 weeks or until on stable dose of medication
- again at 24-28 weeks
- again 32 to 34 weeks
hyperthyroid
predisposes woman to - HF - placental abruption - preeclampsia - preterm delivery Fetus to - goiters - IUGR - small for gestational age - stillbirth - thyroid dysfunction related to maternal tx
tx of hyperthyroid
teratogenic effects
