Pregestational Conditions Flashcards
The most dangerous time for pregnant women to develop cardiovascular conditions
28-32 weeks
Cardiovascular Conditions
- Congenital heart
anomaly (ASD,
uncorrected coarctation
of the aorta) - Rheumatic heart disease
- Kawasaki disease
- Marfan syndrome
- Left-sided Heart Failure
- Right-sided Heart
Failure
New York Heart Association
Heart Failure Classification
Class I: Uncompromised
Class II: Slightly Compromised
Class III: Markedly Compromised
Class IV: Severely Compromised
Heart Failure Class I: Uncompromised
No symptoms of cardiac insufficiency ang no angina pain with ordinary activity
Heart Failure Class II: Slightly Compromised
Ordinary activities causes excessive fatigue, palpitation, dyspnea, or angina pain
Heart Failure Class III: Markedly Compromised
Patient can complete pregnancy through complete bedrest. To facilitate delivery the physician will use forceps.
Heart Failure Class IV: Severely Compromised
Patient is poor candidate of pregnancy because of cardiac failure. But a woman with a pacemaker implant can also to complete the pregnancy.
Nursing Assessment for Cardiovascular Conditions
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)
Maternal and Fetal effects of Cardiovascular Conditions
-2-4% chance the baby will inherit the disease.
-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
Diagnostics Test for Cardiovascular Conditions
Auscultation of heart sounds
Chest X-Ray
Cardiac catheterization
Electrocardiogram
Echocardiogram
Medical Managemet in CV Conditions
-Hospitalization for 1- 4 weeks before delivery.
-IV antibiotics PENICILLIN if not allergic to prevent congenital bacterial endocarditis.(eg. AMPICILLIN, AMOXICILLIN, CLINDAMYCIN)
-Heparin if pt. develops coagulation problem
-Thiazide diuretics to treat congestive heart failure.
-Provide chest x ray, ECG, echocardiogram for additional assessment status
Nursing Management CV Conditions
-minimize stress
-promote rest (Full night rest, 2 rest periods during day)
-assess VS and Ecg continually
-monitor I&O + check for edema
-monitor FHR
-pt. lie in lateral position to increase utero
placental blood flow and to level legs while sitting to promote venous return.
-Educate about medications. Digoxin, adenosine, betablockers, calcium-blockers, nitroglycerin.
Treatment for Deep Vein Thrombosis
- BED REST
- IV OR SUBCUTANEOUS
HEPARIN (LMWH) - ASPIRIN
Higher risk for Deep vein thrombosis/
Thromboembolitic disease
aPLAs group ANTIPHOSPHOLIPID antibodies (autoimmune)
Affects up to 6% of all pregnancies, Most frequent seen conditions in Pregnancy, and Most obese adolescents develop type 2
Diabetes Mellitus
a metabolic disorder characterized by hyperglycemia (elevated serum glucose level) resulting from lack of insulin, lack of insulin effect or both.
Diabetes Mellitus
also defined as a disorder of carbohydrates, protein, and fat metabolism
Diabetes Mellitus
T or F: Progestin-only Contraceptives are Recommended in DM Patients
TRUE
T or F: Gestational Diabetes is different from Diabetes Mellitus
TRUE
Normal Blood Sugar Levels
80-120 mg/dL
T or F: Increase in weights put pt. at risk of DVT
TRUE
The body is unable to produce enough insulin and mostly caused by genes and environmental triggers
Type 1 Diabetes
Treatment for Type 1 Diabetes
INSULIN Daily for life
The body becomes insulin resistant, caused b genes an lifestyle factors
Type 2 Diabetes
Treatment for Type 2 Diabetes
Lifestyle Changes and Medications
Symptoms of Diabetes
blurry vision, extreme thirst, frequent urination, weight loss, yeast infection.
A high blood sugar (glucose) that develops during pregnancy and usually disappears after giving birth
Gestational Diabetes
happens when the body cannot produce
enough insulin
T or F: Gestational Diabetes more common in 1ST Trimester
FALSE: It can happen at any stage of pregnancy, but is more common in the second or third trimester
Precipitating/Predisposing Factors of Gestational Diabetes
-history of polycystic ovary syndrome
-history of unexplained fetal or
-perinatal loss
-history of congenital anomaly
-age over 25 years
-overweight
-lack physical activities
-race or ethnicity
-family history of diabetes
Excessive (excretion of urine): osmotic diuresis occurs caused by the glucose high osmotic pressure within renal tubules.
Polyuria
(excessive thirst): results from
extra/intracellular fluid dehydration
Polydipsia
(excessive eating): results from starvation
of cells
Polyphagia
3Ps signs of hyperglycemia
Polyuria, Polydipsia, Polyphagia
Diabetes mellitus and its effects to the fetus
-hydramnios/polyhyrdramnios
-hyperglycemia or hypoglycemia
-macrosomia
