NCM 109

Question 1

 Is an endocrine disorder in which the pancreas cannot
produce adequate insulin to regulate body glucose levels

Answer 1

DIABETES MELLITUS

Question 2

A state characterized by the destruction
of the beta cells in the pancreas that
usually leads to absolute insulin
deficiency.

Answer 2

Type 1

Question 3

A state that usually arises because of
insulin resistance combined with a
relative deficiency in the production of
insulin

Answer 3

Type 2

Question 4

A condition of abnormal glucose
metabolism that arises during pregnancy.
Possible signal of an increased risk for
type 2 diabetes later in life.

Answer 4

GESTATIONAL
DIABETES

Question 5

A state between “normal” and “diabetes”
in which the body is no longer using
and/or secreting insulin properly.

Answer 5

IMPAIRED
GLUCOSE
HOMEOSTASIS

Question 6

a state
when fasting plasma glucose is
at least 110 but under 126 mg/dl

Answer 6

Impaired fasting glucose:

Question 7

a
state when results of the oral
glucose tolerance test are at
least 140 but under 200 mg/dl in
the 1-hour sample

Answer 7

Impaired glucose tolerance:

Question 8

high glucose concentration causes extra fluid to shift
and enlarge the amount of amniotic fluid.

Answer 8

Hydramnios

Question 9

may create birth problems at the end of the
pregnancy because of CPD.

Answer 9

macrosomic infant

Question 10

 Obesity
 Age over 25 years
 History of large babies (10 lb or more)
 History of unexplained fetal or perinatal loss
 History of congenital anomalies in previous pregnancies
 History of polycystic ovary syndrome
 Family history of diabetes (one close relative or two distant
ones)
 Member of a population with a high risk for diabetes (Native
American, Hispanic, Asian)

Answer 10

RISK FACTORS FOR DEVELOPING GESTATIONAL
DIABETES:

Question 11

o Greater than or equal to 126 mg/dl or a nonfasting
plasma glucose greater than or equal to 200 mg/dl
meets the threshold for the diagnosis of diabetes and
does not need confirmation.
 NPO for 8 hrs. before the test

Answer 11

FASTING PLASMA GLUCOSE (FBS)

Question 12

o Between 24 and 28 weeks’ gestation to determine if
they are at risk for gestational diabetes.

Answer 12

50-G GLUCOSE CHALLENGE TEST

Question 13

o The woman drinks an oral 100-g glucose solution;
o A venous blood sample is then taken for glucose
determination at 1, 2, and 3 hours later.
o If two of the four blood samples collected for this test
are abnormal or the fasting value is above 95 mg/dl,
a diagnosis of diabetes is made

Answer 13

ORAL GLUCOSE TOLERANCE TEST (OGTT)

Question 14

is an automatic pump with thin tubing,
which is placed subcutaneously, most often on the woman’s
abdomen.

Answer 14

insulin pump

Question 15

Normal level of serum creatinine for pregnant women:

Answer 15

0.4 –
0.8 mg/dl

Question 16

(i.e., a small amount of
amniotic fluid) may indicate fetal growth
restriction or a fetal renal abnormality

Answer 16

Oligohydramnios

Question 17

(i.e., an excessive amount of
amniotic fluid) may indicate gastrointestinal
malformation or poorly controlled disease.

Answer 17

Polyhydramnios

Question 18

is usually performed by week 36 of pregnancy to
assess fetal lung maturity

Answer 18

lecithin/sphingomyelin ratio by amniocentesis

Question 19

he most hazardous times for a fetus during a diabetesinvolved pregnancy are
o Because of his or her large size.

Answer 19

weeks 36 to 40 of pregnancy.

Question 20

 A form of high blood pressure in pregnancy
 A condition in which vasospasm occurs in both small and
large arteries during pregnancy
 Also called as TOXEMIA or PREECLAMPSIA
it occurs in about 5 to 7% of all pregnancies

Answer 20

pregnancy Induced Hypertension

Question 21

or the presence of
antiphospholipid antibodies in maternal blood

Answer 21

antiphospholipid syndrome

Question 22

o High blood pressure that is present before
pregnancy begins

Answer 22

Chronic Hypertension

Question 23

 BP 140/90 mmHg or
 Systolic BP > 30 mmHg; Diastolic 15 mmHg above
pregnancy level
 No proteinuria nor edema
 BP returns to normal after birth

Answer 23

GESTATIONAL HYPERTENSION

Question 24

 BP 140/90 mmHg
 Systolic BP > 30 mmHg; Diastolic 15 mmHg above
pregnancy level
 Proteinuria +1 to +2
 Weight gain 2 lbs/wk in 2nd trimester; 1 ln/wk in 3rd
trimester
 Mild edema in upper extremities or face

Answer 24

MILD PREECLAMPSIA

Question 25

 BP 160/110 mmHg
 Proteinuria: 3+ to 4+ on a random sample
 Oliguria: 500 ml or less in 24 hrs
 Pulmonary involvement: shortness of breath
 Hepatic dysfunction
 Epigastric pain due t

Answer 25

SEVERE PREECLAMPSIA

Question 26

o Is most readily palpated over bony surfaces, such as
over the tibia on the anterior leg, the ulnar surface of
the forearm, and the cheekbones, where the
sponginess of fluid-filled tissue can be palpated
against bone.

Answer 26

Extreme edema

Question 27

If there is swelling or puffiness at these points to a
palpating finger but the swelling cannot be indented
with finger pressure, the edema is described as

Answer 27

nonpitting.

Question 28

Seizure or coma occurs
 Signs and symptoms of preeclampsia

Answer 28

eclampsia

Question 29

(5-8 mg/100ml)
 Muscle relaxant
 Prevent seizures

Answer 29

Magnesium sulfate

Question 30

to reduce hypertension (5-
10 mg/IV)
 Lowers BP by peripheral dilatation
 Can Cause tachycardia

Answer 30

Hydralazine (Apresoline)

Question 31

 Antidote for MgSO4 intoxication
 10 ml of a 10% calcium gluconate must be

Answer 31

Calcium gluconate

Question 32

 Halt seizures
 5-10 IV, administer slowly
- Dose may be repeated q 5 to 10 minutes
(up to 30 mg/hr

Answer 32

Diazepam (Valium)

Question 33

PRELIMINARY SIGNS BEFORE SEIZURE

Answer 33

 BP suddenly rises from additional spasm
 Temperature rises (39.4-40°C) from increased cerebral
pressure
 Blurring of vision or severe headache from increased
cerebral edema
 Hyperactive reflexes
 Epigastric pain and nausea from vascular congestion of the
liver or pancreas

Question 34

TONIC-CLONIC SEIZURES
 Tonic Seizures:
o Signs and Symptoms:

Answer 34

 Back arches
 Arms and legs stiffen
 Jaw closes abruptly
 Respirations stop
 Lasts for approx. 20 secs

Question 35

Clonic Seizures:
o Signs and Symptoms:

Answer 35

 Body muscles contract and relax repeatedly
 Inhales and exhales irregularly
 Incontinence of urine and feces may occur
 Lasts up to 1 min
 O2 therapy continued
 MgSO4 or diazepam (Valium) may be
administered via IV as an emergency measure

Question 36

o Semi-comatose
o Extremely close observation is necessary because
seizure may cause premature separation of the
placenta and labor may begin
o Painful stimulus of contraction may initiate another
seizure
o Keep woman on side lying position
o Keep NPO
o Continue monitoring FHR and uterine contractions
o Check for vaginal bleeding every 15 mins

Answer 36

Postictal State: