Nursing Management of the Pregnancy at Risk: Selected Health Conditions and Vulnerable Populations

Question 1

acquired immunodeficiency syndrome (AIDS)

Answer 1

.

Question 2

adolescence

Answer 2

.

Question 3

anemia in pregnancy

Answer 3

iron-deficient diet, gastrointestinal issues affecting absorption, or a short pregnancy interval, reflects poor nutrition, principally attributed to poor economic status worldwide. risk for thromboembolic events, headache, restless legs syndrome, and pica.

Question 4

fetal alcohol spectrum disorder (FASD)

Answer 4

full range of birth defects, such as structural anomalies and behavioral and neurocognitive disabilities.
Autism, Down syndrome, cerebral palsy, cystic fibrosis, spina bifida, and sudden infant death syndrome (SIDS)

Question 5

gestational diabetes mellitus

Answer 5

Glucose intolerance with its onset during pregnancy usually around the 24th week or first detected in pregnancy. The prevalence of gestational diabetes has been increasing in the United States and is as high as up to 10% in the United States.

Question 6

glycosylated hemoglobin (HbA1C) level (recommendations during pregnancy)

Answer 6

First prenatal visit to determine gestational diabetes. a measurement of the average glucose levels during the past 100 to 120 days. glycosylated hemoglobin level of less than 7%, 126 mg/dL <7% 200 mg/dL

Question 7

human immunodeficiency virus (HIV)

Answer 7

.

Question 8

impaired fasting glucose

Answer 8

characterized by hyperglycemia at a level lower than what qualifies as a diagnosis of diabetes, fasting blood glucose level between 100 and 125 mg/dL.symptoms of diabetes are absent; newborns are at risk for being large for gestational age (LGA).

Question 9

impaired glucose tolerance

Answer 9

blood glucose level between 140 and 199 mg/dL after a 2-hour glucose tolerance test; symptoms of diabetes are absent; newborns are at risk for being large for gestational age (LGA)..

Question 10

multiple sclerosis (MS)

Answer 10

inflammatory course of MS, autoreactive T cells cross the blood–brain barrier, attacking myelin proteins and leading to inflammation and demyelination.

Question 11

neonatal abstinence syndrome (NAS)

Answer 11

effect of heroin and other narcotics on newborns is withdrawal: collection of symptoms may include irritability, hypertonicity, jitteriness, fever, excessive and often high-pitched cry, vomiting, diarrhea, feeding disturbances, respiratory distress, disturbed sleeping, excessive sneezing and yawning, nasal stuffiness, diaphoresis, fever, poor sucking, tremors, and seizures.

Question 12

perinatal drug abuse

Answer 12

the use of alcohol and other drugs by pregnant women.

Question 13

pregestational diabetes

Answer 13

alteration in carbohydrate metabolism identified before conception. 9x higher risk of birth defects, detected in the first 24 weeks.

Question 14

rheumatoid arthritis (RA)

Answer 14

joint inflammation and progressive disability and is one of the most common chronic autoimmune disorders.

Question 15

systemic lupus erythematosus (SLE)

Answer 15

relapsing autoimmune disease of the connective tissues that can affect various organs, such as the skin, joints, kidneys, and serosal membranes.

Question 16

teratogen

Answer 16

a substance known to be toxic to human development (pregnancy).

Question 17

type 1 diabetes

Answer 17

Absolute insulin deficiency (due to an autoimmune process); usually appears before the age of 30 years; approximately 5% % of those diagnosed have type 1 diabetes..

Question 18

type 2 diabetes

Answer 18

Insulin resistance or deficiency (related to obesity, sedentary lifestyle); diagnosed primarily in adults older than 30 years of age but now being seen in children; the most common type of diabetes. It is more common in African Americans, Latinos, Native Americans, and Asian Americans/Pacific Islanders, as well as older adults.

Question 19

What does OGTT stand for (hint: think pregnancy)

Answer 19

oral glucose tolerance test

Question 20

Tetralogy of Fallot

Answer 20

Congenital defect involving four structural anomalies: obstruction to pulmonary flow; ventricular septal defect (abnormal opening between the right and left ventricles); dextroposition of the aorta (aortic opening overriding the septum and receiving blood from both ventricles); and right ventricular hypertrophy (increase in volume of the myocardium of the right ventricle).

Question 21

Atrial septal defect (ASD)

Answer 21

Congenital heart defect involving a communication or opening between the atria with left-to-right shunting due to greater left-sided pressure.

Arrhythmias present in some women.

Question 22

Ventricular septal defect (VSD)

Answer 22

Congenital heart defect involving an opening in the ventricular septum, permitting blood flow from the left to the right ventricle. Complications include arrhythmias, heart failure, and pulmonary hypertension.

Question 23

Patent ductus arteriosus

Answer 23

Abnormal persistence of an open lumen in the ductus arteriosus between the aorta and the pulmonary artery after birth; results in increased pulmonary blood flow and redistribution of flow to other organs.

Question 24

Management of Tetralogy of Fallot

Answer 24

Hospitalization and bed rest possible after the 20th week with hemodynamic monitoring via a pulmonary artery catheter to monitor volume status

Oxygen therapy may be necessary during labor and birth.

Question 25

Management of Atrial septal defect (ASD)

Answer 25

Treatment with atrioventricular nodal blocking agents, and at times with electrical cardioversion.

Question 26

Management of Ventricular septal defect (VSD)

Answer 26

Rest with limited activity if symptomatic.

Question 27

Management of Patent ductus arteriosus

Answer 27

Surgical ligation of the open ductus during infancy; subsequent problems minimal after surgical correction.

Question 28

Tuberculosis in pregnancy

Answer 28

Pregnant women with untreated TB are more likely to have an underweight infant, an infant with a low Apgar score, and perinatal death.
Tx: INH, rifampin, and ethambutol daily for 2 months, followed by INH and rifampin daily, or twice weekly for 7 months. Women taking INH should also be taking pyridoxine (vitamin B6) supplementation

Question 29

Thalassemia

Answer 29

low Hgb and a microcytic, hypochromic anemia results. Alpha-thalassemia (minor), the heterozygous form, results from the inheritance of one abnormal gene from either parent. Beta-thalassemia major Beta-thalassemia (major) is the form involving inheritance of the gene from both parents. can be very severe.