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OB - NCM109 Care of Mother and Child at Risk or with Problems (Acute and Chronic) > Pregestational Conditions > Flashcards

Pregestational Conditions Flashcards

1
Q
  • Valve Damage
  • Caused by recurrent episodes of Acute Rheumatic Fever (ARF)
    – Heart has become inflamed
    – Heart valves remain stretched and/or scarred normal blood flow is interrupted
A

Rheumatic Heart Disease

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2
Q

___ is damage to the heart that remains after an Acute Rheumatic Fever episode has resolved

A

Rheumatic Heart Disease

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3
Q
  • Illness caused by “group A streptococcus”
  • Causes acute, generalized inflammatory response
A

Acute Rheumatic Fever (ARF)

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4
Q

Recurrence of ARF = _____?

A

Cardiac Valve Damage

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5
Q

Acute Rheumatic Fever targets which specific parts:

A
  1. Heart
  2. Joints
  3. Brain
  4. Skin
    (Leaves no damage on 2-4)
  • Has persisting HEART damage (RHD)
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6
Q

Dyspnea (Normally During Pregnancy)

A
  • Increase mother’s blood volume (30-50%)
    – Half of this increase occurs during the 8th week of pregnancy
  • There is functional (innocent) or Transient heart murmurs
    (transient = temporary)
  • Heart palpitations on sudden exertion
  • Cardiac output falls (vital organs, placenta are no longer perfused adequately)
  • Mother and Baby’s O2 and Nutritional req. are not met
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7
Q

Most dangerous time for mother’s with Dyspnea?

A

28-32 weeks

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8
Q

Dyspnea (Management)

A
  • Team approach
    1. Internist-Cardiologist
    2. Obstetrician
    3. Nurse
  • Should visit Obstetrician before planning to get pregnant (baseline status)
    –Advise to cease work

DIAGNOSTICS
- Echocardiography to assess valvular function

  • Successful completion of pregnancy
    – Depends upon the type extent of disease
  • Woman with artificial but well functioning heart valves
    – Consistent prenatal and postpartum care
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9
Q

Preventing recurrences of ARF

A

Prophylactic treatment with penicillin

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10
Q
  • An Endocrine Disorder in which the pancreas cannot produce adequate insulin to regulate body glucose levels
A

Diabetes Mellitus

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11
Q

Diabetes Mellitus affects ___% of all pregnancies

A
  • 3-5% of pregnancies
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12
Q

Most frequently seen medical condition in pregnancy

A
  • Diabetes Mellitus
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13
Q

Diabetes Mellitus (Classification)

A
  1. Type 1
    - Insulin - dependent DM
  2. Type 2
    - Non-insulin - dependent DM
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14
Q
  • Abnormal glucose metabolism that arises during pregnancy
  • Symptoms fade again at the completion of pregnancy
A

Gestational Diabetes Mellitus

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15
Q

Gestational Diabetes Mellitus (Risk Factors)

A
  1. Obesity
  2. Age < 25 years
  3. History of Large Babies (10lbs or more)
  4. History of unexplained fetal or perinatal loss; congenital anomalies in previous pregnancies; polycystic ovary syndrome; diabetes
  5. Member of a population with a high risk for diabetes
    - Native American
    - Hispanic
    - Asian
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16
Q
  • A state between normal and diabetes
  • Body is no longer using and/or secreting insulin properly
A

Impaired Glucose Homeostasis

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17
Q

Gestational Diabetes Mellitus (Normally)

A
  • Develops insulin resistance (insulin seems to be ineffective during pregnancy)
  • Placental insulinase may cause increased breakdown of insulin
    – Helpful because it prevents blood glucose from falling to dangerous limits
    – Insulin dosage is increased beginning about 24 weeks to prevent hyperglycemia
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18
Q

Insulin is ineffective during pregnancy due to?

A
  • Presence of Human Placental Lactogen
  • High levels of:
    1. Cortisol
    2. Estrogen
    3. Progesterone
    4. Catecholamine
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19
Q

Gestational Diabetes Mellitus (Signs and Symptoms)

A
  1. Hypoglycemia
    - Continued use of glucose by the fetus
    - Opt to occur overnight
    - Ketoacidosis (during 2nd and 3rd Trimester)
  2. Polyuria
    - Excessive urination
  3. Polydipsia
    - Excessive thirst
  4. Polyphagia
    - Excessive or extreme hunger
  5. Fatigue
  6. Blurred Vision
  7. Weight loss
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20
Q

Gestational Diabetes Mellitus (Primary Problem)

A
  • Controlling the balance between insulin and blood glucose levels
    – Prevent hyper and hypoglycemia
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21
Q

Gestational Diabetes Mellitus (Management)

A

Reproductive Planning

  • Oral Contraceptives are NOT allowed
    – Progesterone interferes with insulin activity (increases blood glucose levels)
    – Estrogen has the potential for increasing cholesterol and lipid levels and blood coagulation
  • IUD
    – Associated with Pelvic Inflammatory Disease (PID) (women with DM have difficulty fighting infections)
  • Subcutaneous implanted or IM injections of progestin are good choices
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22
Q

Gestational Diabetes Mellitus (Maternal and Fetal Risk)

A

Maternal Risk:
1. Maternal Pelvic Inflammatory Disease (PID)
2. Infection (Monilial Infection)
3. Spontaneous Miscarriage

Fetal Risk:
1. Growth Restriction
2. Asphyxia
3. Stillbirth
4. Macrosomic - Large for gestational age
- Possible problem with Cephalopelvic Disproportion (CPD)
- Increased risk for shoulder dystocia
5. Congenital Anomaly
- Caudal regression syndrome
– Failure of the lower extremities to develop

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23
Q

Gestational Diabetes Mellitus (Management)

A
  • Keep woman from hyperglycemia
    – Less chance for congenital anomaly
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24
Q

Substance Abuse results in?

A
  1. Miscarriage
  2. Low Birth Weight (LBW)
  3. Premature Labor
  4. Placenta abruptio
  5. Fetal Death
  6. Maternal Death
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25
Q

Subtances Include:

A
  1. Marijuana
    - pot, weed, grass and reefer
  2. Cocaine (coca plant)
    - bump, toot, C, coke, crack, flake, snow, and candy
  3. Heroin
    - horse, smack, junk, and H-stuff
  4. Phencyclidine (PCP) and Lysergic Acid Diethyl-amide (LSD)
    - PCP: angel dust, KJ (kristal joint), illy, or wet
    - LSD: acid, tabs, sugar cubes, hits, or doses
  5. Methamphetamine (Shabu)
    - meth, speed, crystal, glass, and crank
  6. Alcohol
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26
Q

Substances: Marijuana

A
  • pot, weed, grass and reefer
  • Crosses the placenta to your baby
    – Contains toxins that keep your baby from getting the proper supply of oxygen
    – Increases the levels of carbon monoxide and carbon dioxide in the blood
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27
Q

Substances: Cocaine (Coca Plant)

A
  • bump, toot, C, coke, crack, flake, snow, and candy
  • Crosses the placenta and enters your baby’s circulation
  • The elimination of cocaine is slower in a fetus than in an adult

According to Organization of Teratology Information Services (OTIS)

  • during the early months of pregnancy
    – increase the risk of miscarriage
  • Later in pregnancy
    – cause placental abruption
    – can lead to severe bleeding, preterm birth, and fetal death
    – There is a greater risk of birth defects
  • Learning difficulties may result as the child gets older
  • Defects of the: genitals, kidneys, and brain are also possible
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28
Q

Cocaine: According to the American Congress of Obstetricians and Gynecology (ACOG)

  • There is a __% increased chance of premature labor
A

25%

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29
Q

Babies born to mothers who use cocaine throughout their pregnancy:

A
  1. have a smaller head
  2. growth is restricted
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30
Q

Infants are born dependent on __ and suffer from withdrawal symptoms:

A

Cocaine

  1. Tremors
  2. sleeplessness
  3. muscle spasms
  4. feeding difficulties
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31
Q

Substances: Heroin

A
  • Horse, smack, junk, and H-stuff
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32
Q

Mothers who inject narcotics are more susceptible to ___?

A

Human Immunodeficiency Virus (HIV)

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33
Q

Unborn baby can become dependent on the drug

A

Heroin

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34
Q

In terms of childbirth, heroin increases the chances of:

A
  1. premature birth
  2. low birth weight
  3. breathing difficulties
  4. low blood sugar (hypoglycemia)
  5. bleeding within the brain (intracranial hemorrhage)
  6. infant death
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35
Q

Mothers who have used heroin, the babies can suffer from withdrawal symptoms: which are?

A
  • Irritability
  • Convulsions
  • Diarrhea
  • Fever
  • sleep abnormalities
  • joint stiffness
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36
Q

Substances: Phencyclidine (PCP) & Lysergic Acid Diethyl-amide (LSD)

A
  • hallucinogens
  • (PCP): angel dust, KJ (kristal joint), illy, or wet
  • (LSD): acid, tabs, sugar cubes, hits or doses
  • Users can behave violently
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37
Q

Intaking Phencyclidine (PCP) and Lysergic Acid Diethyl-Amide (LSD) can lead to:

A
  1. Low birth weight (LBW)
  2. Poor muscle control
  3. Brain damage
  4. Withdrawal syndrome if used frequently
    - Lethargy, alternating with tremors
  5. Birth defects
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38
Q

Also called as: meth, speed, crystal, glass, and crank

A

Methamphetamine

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39
Q

Methamphetamine causes the heart rate of the mother and baby to _____?

A

Increase

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40
Q

Mothers who have used methamphetamine can result in the baby to get _____, which can lead to _____.

A

less oxygen, Low Birth Weight (LBW)

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41
Q

Mothers who have used methamphetamine can result in:

A
  • Premature labor
  • Miscarriage
  • Placental abruption
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42
Q

When the mother consumed methamphetamine during her pregnancy, the child can experience these withdrawal symptoms:

A
  • Tremors
  • Sleeplessness
  • muscle spasms
  • feeding difficulties
  • learning difficulties may result as the child gets older
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43
Q

Substances: Alcohol

A
  • Cause miscarriages
  • Premature birth
  • Increase the risk stillborn baby
  • Can permanently damage baby’s cells
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44
Q

An alcoholic mother can damage the baby’s ____?

A

Nervous system

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45
Q

If the mother is an alcoholic, the baby can develop _____?

A

Baby develops Fetal Alcohol Spectrum Disorders (FASD)

  • mild learning difficulties or social problems
  • birth defects
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46
Q

Fetal Alcohol Syndrome (FAS)

A
  • Facial defects
  • Small (even as they age)
  • Learning difficulties
  • Poor muscle tone and coordination
  • Behavioral problems
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47
Q

Fetal Alcohol Syndrome (FAS): Defects

A
  • Small head
  • Low nasal bridge
  • Epicanthal folds
  • Small eye openings
  • Flat midface
  • Short nose
  • Smooth philtrum
  • Thin upper lip
  • Underdeveloped jaw
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48
Q

A virus that weakens the body’s immune system

A

Human Immuno-Virus (HIV)

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49
Q

HIV causes ____?

A

AIDS (Acute Immunodeficiency syndrome)

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50
Q

A disease that hurts the body’s ability to fight
infection and certain cancers

A

AIDS (Acute Immunodeficiency syndrome)

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51
Q

An HIV carrier should?

A
  • Stay healthy
  • Do not spread the virus
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52
Q

HIV spreads through what body fluids?

A
  • Blood
  • Semen
  • Vaginal fluids
  • Breast milk (minimal risk)
  • Some body fluids that may be handled by health care workers
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53
Q

HIV: Common modes of transmission

A
  • Sexual intercourse (vaginal, anal, or oral) with a person who has HIV
  • Sharing needles with someone who has HIV, such as when using drugs
  • Pregnancy, labor, birth, or breastfeeding if a mother has HIV (not anymore)
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54
Q

HIV: LESS Common modes of transmission

A
  • Blood transfusion from an HIV positive blood donor
  • Eating food that has been pre-chewed by an HIV-infected person
    – The blood in a caregiver’s mouth can mix with food while chewing (very rare)
  • Using a dirty tattooing needle (if it was used before on someone with HIV)
    – Make sure the needle is new
  • Sharing a toothbrush or razor with someone who has HIV
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55
Q

HIV is not spread through?

A
  • Kissing (there is a small chance of getting HIV from open-mouthed or “French” kissing if there’s contact with blood)
  • Touching, hugging, or handshakes
  • Sharing food or drinks
  • Sharing food utensils, towels and bedding, telephones, or toilet seats
  • Donating blood
  • Working with or being around someone with HIV
  • Biting insects, such as mosquitoes
  • Swimming pools or drinking fountains
  • Playing sports
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56
Q

Risk of giving HIV to your newborn is below __%?

A

2 percent

  • Mother and the baby must get the right HIV drugs at the right times
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57
Q

A mother with HIV; Breastfeeding is not allowed. TRUE or FALSE?

A

FALSE. Already allowed

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58
Q

Lowering the risk of giving HIV to babies

A
  • Get as healthy as possible before becoming pregnant
  • Let the baby is tested for HIV right after birth
    – start treatment for the baby diagnosed with HIV
    – may require a number of tests (done when baby is 2 to 4 months old)
    – New research shows that putting a newborn on a 2- or 3-drug anti-HIV medicine plan cuts the infant’s risk of HIV by 50 percent (compared to using one drug only)
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59
Q

Start HIV treatment before pregnancy

A
  • Start treatment during pregnancy
  • If already on treatment, do not stop, but see the doctor right away
    – Some HIV drugs should not be used during pregnancy
    – For other drugs, a different dosage is needed
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60
Q

A protein present on the surface of RBC

A

Rh factor

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61
Q

A fetus can only inherit the Rh factor if the (parent) ___ is positive?

A

an Rh+ Father

62
Q

If both parents are negative (-) with the Rh factor, the fetus will be?

A

The fetus will be negative (-)

63
Q

What happens if the mother’s first delivery has the Rh factor?

A

The Rh positive (+) antigen is passed from baby to mother which will make an antibody resistant to Rh + red blood cells (RBC)

64
Q

What happens if the mother’s second pregnancy has the Rh factor?

A

Antibodies created from the first delivery will make the mother Rh sensitized and destroy the second fetus’s Rh positive (+) red blood cells (RBC)

65
Q

What preventive measure should be given to the Rh negative (-) mother before second pregnancy to prevent Rh disease

A

Antibody screening is done (blood test)

66
Q

Destroys the fetal red blood cells (RBC)

A

Hemolytic anemia

67
Q

Rh negative (-) mothers will be given _____ to prevent the production of Rh antibodies

A

Rh Immunoglobulin (RhIg)

68
Q

Rh Immunoglobulin (RhIg) is made from?

A

Made from donated blood

69
Q

Rh Immunoglobulin (RhIg) will not be helpful to mothers who are?

A

Already sensitized to Rh positive (+) blood

70
Q

Rh Immunoglobulin (RhIg) is given to mothers in the following situations:
- At around ____ week of pregnancy
- Within ____ after delivery of an Rh positive (+) infant
- After ____, ____, ____, ____, ____

A

28th week
72 hours
after:
1. Miscarriage
2. Abortion
3. Ectopic Pregnancy (outside the main cavity of the uterus)
4. Amniocentesis
5. Chorionic villi sampling

71
Q

What should the nurse do if the mother is Rh sensitized and fetus is Rh positive (+)

A

Monitor during pregnancy

72
Q

What will happen if the fetus has severe anemia?

A
  • Early delivery of the baby (before 37 weeks of gestation)
  • Blood transfusion through the umbilical cord
73
Q

What will happen if the fetus has mild anemia?

A
  • Delivery at normal time
  • Blood transfusion (BT) After delivery
74
Q
  • Most common
    – Diet low in iron
    – Heavy menstrual period
    – Unwise weight reduction program
A

Iron-Deficiency Anemia

75
Q

Small red blood cells

A

Microcytic

76
Q

Less Hemoglobin red blood cell

A

Hypochromic

77
Q

Hypochromic:
- Hemoglobin (Hgb), hematocrit (hct), serum transferrin level, transferrin saturation level, serum iron level, and mean copuscal level will ____?
- Iron-binding capacity will ___?

A
  • Increase
  • Decrease
78
Q

Iron-deficiency Anemia is mildly associated with:

A
  • low-birth weight
  • preterm birth
79
Q

Craving and eating of substances

A

Pica

80
Q

Ineffective oxygen transport causes _____ and _____.

A

Extreme fatigue, and poor exercise

81
Q

Prevention of Iron-deficiency Anemia include:

  • Iron supplemental vitamins of _____
  • Eating foods high in _____ and _____
A
  • 60 mg of elemental iron (prophylaxis)
  • Iron and vitamins
82
Q

examples of food that are high in iron and vitamins:

A
  • Green leafy vegetables
  • Meat
  • Legumes
  • Fruit
83
Q

A mother diagnosed with Iron-deficient Anemia should take:

A

120-200 mg elemental iron/day (ferrous sulfate/ferrous gluconate)

84
Q

Elemental iron should be taken with the following instructions:

A
  • Taken with acid (orange juice or vitamin C supplement)
  • Increase roughage in the diet and take with food (prevent constipation)
  • Caution women that stools stool turns black
  • If with difficulty tolerating oral iron supplements
    – Intravenous iron dextran
85
Q
  • Folacin
  • One of B vitamins
  • Necessary for normal formation of RBC
  • Prevents neural defects in fetus
A

Folic acid

86
Q

Folic acid-deficiency anemia is seen in _____% in pregnancies

A

1-5%

87
Q

Folic acid-deficiency anemia occurs most often in women with the following:

A
  • Multiple pregnancies (increased fetal demand)
  • Secondary hemolytic illness (rapid destruction and production of new RBC)
  • Taking hydantoin (anticonvulsant agent that interferes with folate absorption)
  • Taking oral contraceptives
  • Gastric bypass for morbid obesity
88
Q

Folic acid-deficiency anemia results to:

A

Megaloblastic Anemia
- Enlarged red blood cell (RBC)
- Elevated mean corpuscular volume

89
Q

Folic acid-deficiency anemia is apparent during the ___ timester

A

second (2nd)

  • Take several weeks to develop

Contributory factor in early miscarriages and premature separation of placenta

90
Q

Women expecting to be pregnant should do the following to PREVENT Folic acid-deficiency anemia:

A
  • Take supplements of 400 microgram folic acid daily
  • Eating of foods rich in folic acid
    – Green leafy vegetables
    – Oranges
    – Dried beans
91
Q

During pregnancy, folic acid supplement is increased to
___?

A

600 micrograms

92
Q

Recessively inherited hemolytic anemia

A

Sickle-cell anemia

93
Q

Sickle-cell anemia is caused by ___?

A

abnormal amino acid in beta chain of hemoglobin

  • Abnormal amino acid replaces the amino acid valine—-sickle hgb (HbS) results
  • If substituted for amino acid lysine—–non-sickling hgb (HbC) results
94
Q

_____ (has only one gene in which the abnormal substitution has occurred

  • has the sickle-cell trait (HbAS)
A

Heterozygous

95
Q

____ (two genes in which the substitution has occurred)

  • sickle-cell disease (HbSS) results
A

Homozygous

96
Q

does a HbA - HbA child inherit the sickle-cell disease from their parents?

A

No. They are normal

97
Q

does a HbA - HbS child inherit the sickle cell disease from their parents?

A

No. But they are a carrier of the sickle-cell trait

98
Q

does a HbS - HbS child inherit the sickle cell disease from their parents?

A

Yes. They suffer from sickle-cell disease

99
Q

Sickle-cell anemia: Majority of red blood cells (RBC) are irregularly shaped (____ shaped)

A

sickle shaped

100
Q

Sickle-shaped red blood cells cannot carry as much of what?

A

Hemoglobin (hgb)

101
Q

Sickle-cell anemia: Red blood cells (RBC) tend to ____?

A

Red blood cells (RBC) tend to clump

  • Oxygen tension becomes reduced (high altitude)
  • Blood becomes viscid than usual (dehydration)
  • Results to vessel blockage——reduced blood flow to organs—hemolysis of cells—–severe anemia
102
Q

If there is a blockage to placental circulation due to sickle-cell anemia, it can result to:

A
  • Low-birth weight (LBW)
  • Fetal death
103
Q

Women with homozygous disease has a high incidence of:

A
  • prematurity
  • miscarriage
  • perinatal mortality
104
Q

Women with trait has a high incidence of?

A

Asymptomatic bacteriuria

  • increased incidence of pyelonephritis
105
Q

Sickle-cell anemia (Management)

A

Assessment

  • Clean-catch urine is collected periodically
  • Monitor woman’s diet
  • Monitor fluid intake (at least 8 glasses per day)
  • Assess varicosities
  • Fetal health monitoring (ultrasound) at 16-24 weeks
106
Q

(Therapeutic) Sickle-cell anemia: Replace sickled cells with non-sickled cells throughout pregnancy

A

Periodic exchange transfusions

107
Q

(Therapeutic) Sickle-cell anemia: During crisis

A
  • Pain management
  • Administer oxygen
  • Increase fluid volume (lower viscosity)
108
Q

(Therapeutic) Sickle-cell anemia: No iron supplements

A
  • Sickled cells cannot incorporate iron—results to iron build up
  • No need for folic acid supplements
109
Q

(Therapeutic) Sickle-cell anemia: If there is infection

A

Hospitalization.
(rule out crisis and hemolysis of crowded cells)

110
Q

(Therapeutic) Sickle-cell anemia: Mature fetus

A
  • Individualized method of delivery
  • Keep woman hydrated in labor
  • Epidural anesthesia if operation is needed
    – General anesthesia poses a possible risk of hypoxia
111
Q

(Therapeutic) Sickle-cell anemia: Pospartum

A
  • Early ambulation
  • Wearing of pressure stockings
    – Reduce risk of thromboembolism
112
Q

Causative agent: Escherichia coli

A

Urinary Tract Infection (UTi)

113
Q

Ureters _____ because of progesterone—results to stasis urine

A

dilate

114
Q

Allows more than the usual number of organisms to grow

A

Minimal glucosuria

115
Q

Asymptomatic infections are dangerous because?

A
  • Can progress to pyelonephritis (infection of the pelvis of the kidneys)
  • Associated with preterm labor
  • Premature rupture of membranes
116
Q

Urinary Tract Infection: Symptomatology

A
  • Frequency
  • Pain in urination
  • Pain in lumbar region (right side) that radiates downward
    – greater compression and urinary stasis on the right ureter from the uterus being pushed that way by the bulk of the intestines on the left side
  • Tender to palpation
  • Accompanying nausea and vomiting
  • Malaise
    – A general feeling of discomfort, illness, or uneasiness
  • Pain
  • Frequency of urination
  • Elevated temperature
  • Urine culture (over 100,000 organisms/ml)
117
Q

(Management) Urinary Tract Infection: How to determine which antibiotic will best combat the infection?

A

By sensitivity testing

118
Q

(Management) Urinary Tract Infection: _____, _____,and _____ are effective against most organisms causing UTI

A

Amoxicillin
Ampicillin
Cephalosporins
- Safe during pregnancy

119
Q

(Management) Urinary Tract Infection: Cause retardation of bone growth and staining of fetal death

A

Tetracyclines
- Contraindicated in pregnancy

120
Q

Sulfonamides can be used early in pregnancy. TRUE or FALSE?

A

True

121
Q

Why can’t you give Sulfonamides near term?

A

Because it can interfere with protein binding of bilirubin which can lead to hyperbilirubinemia in newborn

122
Q

Renal disease: Symptomatology

A
  • Severe anemia
  • Proteinuria
    – Must be compared to woman’s individualized pre-pregnancy level too be meaningful)
  • Elevated blood pressure (BP)
    – Should be compared with pre-pregnancy level
123
Q

(Symptomatology) Renal disease: Diseased kidneys do not produce erythropoietin

A

Severe anemia
- Synthetic erythropoietin is available

124
Q

(Physiology-Pregnancy) Renal disease: Glomerular filtration rate (GFR) is normally ____?

A

increased

125
Q

(Physiology-Pregnancy) Renal disease: Is advised not to get pregnant (danger of kidney failure)

A

Women who have an increased serum creatinine
level of more than 2 mg/dl

126
Q

(Physiology-Pregnancy) Renal disease: What is the normal value of serum creatinine level?

A

Normal: 0.7 mg/dl

127
Q

Renal disease: Management

A

Corticosteroid (oral prednisone) level at a maintenance level

  • Continued throughout pregnancy
  • Infant maybe hyperglycemic at birth (because of suppression of insulin activity

Dialysis

  • Risk of preterm labor (progesterone is removed during dialysis)
    – Progesterone is administered IM before the procedure
  • Scheduled frequently and for short duration
    – Prevent acute fluid shifts

Heparin injected during hemo is safe (does not cross the placenta)
Nutrition consultation

  • Low potassium diet (avoid buildup of potassium
    that accumulates because their diseased kidneys
    do not evacuate this well

Emotional support

  • Being pregnant is risky
128
Q

Caused by virus
- Type A, B or C
Spreads in epidemic form
Can cause preterm labor

A

Influenza

129
Q

Influenza: Symptomatology

A
  • High fever
  • Extreme prostration (exhaustion)
  • aching pains in the back and extremities
  • sore, raw throat
130
Q

Influenza: Treatment

A

Antipyretic

  • acetaminophen-Tylenol

Oral antiviral drug

  • Oseltamivir (TamiFlu)

Influenza vaccine immunization

  • from killed virus
131
Q

Lung tissue is invaded with Mycobacterium tuberculosis

A

Tuberculosis

132
Q

An acid-fast bacillus

A

Mycobacterium tuberculosis

133
Q

Tuberculosis: ____, _____ and a final ring of _____ develop

A
  • Fibrosis
  • Calcification
  • Collagenous scar tissue develop
134
Q

Tuberculosis: Antibodies produced will have a positive _____?

A

Mantoux test

135
Q

Tuberculosis: PPD - Purified protein derivative

A

Mantoux test

136
Q

Tuberculosis: Symptomatology

A
  • Chronic cough
  • Weight loss
  • Hemoptysis
  • Night sweats
  • Low-grade fever
  • Chronic fatigue
137
Q

Tuberculosis: Management

A

(INH) Isoniazid and ethambutol hydrochloride (Myambutol)

  • Drug of Choice (DOC)
  • Non teratogenic
  • INH
    – Result in peripheral neuritis (if no supplement of pyridoxine-B6)

Ethambutol
- Optic nerve involvement
- Test with Snellen’s chart

Calcium supplements to ensure TB pockets are not broken down

138
Q

How many years is it advised to wait before getting pregnant after treating tuberculosis?

A

1-2 years

139
Q

Tuberculosis is transferred to the baby after birth
- Can care for the baby after ___?

A

Three (3) negative sputum cultures

140
Q

(Management) Tuberculosis: If with active TB at home
- Infant given _____?
- Follow-up _____ at ____ interval

A
  • Prophylactic Isoniazid (INH)
  • Skin tests
  • 3 months
141
Q

(Management) Tuberculosis: If with active TB at home
- Mother taking Isoniazid (INH) should not _____?

A

Breastfeed
- or infants dosage should not be reduced

142
Q
  • German measles
  • “Three-day measles”
A

Rubella

143
Q

Rubella: Symptomatology

A
  • Fever
  • Headache
  • Rash
  • Eye pain
  • Back pain
  • Muscle aches
  • Joint pain
144
Q

Rubella is most dangerous to the baby in the first _____ of pregnnacy

A

First 16 weeks

145
Q

Rubella can cuase?

A
  • Miscarriage
  • Stillbirth
146
Q

Birth defects in unborn babies is called?

A

Congenital Rubella Syndrome

147
Q

Congenital Rubella Syndrome include the following birth defects:

A
  • Hearing loss
  • Brain damage
  • Heart defects
    – Patent Ductus Arteriosus (PDA)
  • Cataracts
148
Q

Rubella can be transmitted via:

A
  • Coughs
  • Sneeze
149
Q

MMR vaccine means?

A

Measle, mumps, and rubella vaccine

150
Q

Rubella: Management

A
  • No specific treatment for Rubella
  • Diminish discomfort
  • Treatment of newly born babies is focused on management of the complications
    – Congenital heart defects and cataracts can be corrected by direct surgery
  • Counseling
  • Regular monitoring
151
Q

Key Points: Cheat Sheet

A

Rh factor is only released from the Rh (+) fetus during breakdown of RBC

  • Delivery of placenta

If mother is Rh (+) and fetus is Rh (-) no incompatibility will happen

  1. When a woman with preexisting disease become pregnant, it is crucial to obtain a thorough history and physical examination on the condition
    - Documentation by a medication reconciliation form of any medication being taken is important to protect against adverse drug interactions and the possibility of teratogenic effects on the fetus
  2. Teaching is an important nursing intervention because a woman with preexisting illness must *modify her usual therapy to adjust to pregnancy**.
  3. Because blood volume increases by as much as 50% during pregnancy, cardiac function may become inadequate if cardiovascular disease is present
    - Cardiac illness that cause difficulty can be either acquired disorders (KAWASAKI; rheumatic fever) or congenital disorders (mitral valve stenosis; coarctation of aorta)
  4. All forms of anemia can result to fetal distress because of inadequate oxygen transport
  5. UTI can lead to pregnancy complication (increase workload in the kidneys)
  6. Acute nasopharyngitis, asthma, pneumonia, influenza, and TB are common respiratory disorders seen in pregnancy
  7. Juvenile rheumatoid arthritis and systemic lupus erythematosus are example of rheumatoid disorders seen in pregnancy
    - Require large doses of NSAIDS
    - Those taking salicylates are advised to decrease use 2 weeks before birth (avoid bleeding)
  8. If surgery is necessary during pregnancy (cholecystectomy/appendectomy), can be performed by laparoscopic technique but may result in preterm labor
  9. Recurrent seizures are the most frequently seen neurologic condition during pregnancy
  10. Major endocrine disorder seen in pregnancy is diabetes (Gestational diabetes)

OB - NCM109 Care of Mother and Child at Risk or with Problems (Acute and Chronic) (3 decks)

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