risk factors, causes and symptoms CP1 Flashcards
risks associated with anaemia
- pre term birth
- IUGR
- fetal hypoxia
- 50% increase in PPH risk
symptoms of anaemia
dizziness
increased respiratory rate
tachycardia
inflammation or soreness of the tongue
symptoms of superficial VTE
redness, tenderness and swelling along vein
symptoms of VTE getting worse / pulmonary embolism
increased / unmanageable pain
unilateral oedema
shortness of breath
fever
unable to bear weight on affected leg
redness spreading
asthma pathophysiology
bronchoconstriction
airway inflammation
mucus impaction
stimuli causes inflammation leading to broncho-constriction, hypersecretion of mucosa and mucosal oedema, making ventilation difficult, reducing air intake and external respiration leading to tissue hypoxia.
uncontrolled asthma increases the risk of what possible complications?
- PIH
- pre-eclampsia
- congenital abnormalities
- IUGR
- Preterm labour
triggers (stimuli) for asthma attacks
- allergies
- respiratory infections
- exercise
- anxiety and stress
- environmental toxins / stimuli such as pollen
complications in pregnancy from PCOS
- GDM
- PIH
- PET
- LGA
- Preterm labour
- miscarriage
considerations or actions for a high BMI woman in labour
- positions / being mobile - use the features of the bed
- swiss ball
- utilise support people for mobilisation
- encourage getting up to the shower for pain relief
- wireless ctg or ctg stickers
- water-birth contraindicated
Post caesarean considerations for a high BMI woman
more prone to infection, haemorrhage and thrombosis.
- turn regularly to avoid pressure sores
- early mobilisation - if not moving lower legs
- take out catheter to encourage mobilisation
- more frequent observations of MEWS and lochia
- breastfeeding support
- wound care, changing dressing, assessing site.
- educating about keeping wound clean and dry and educating about signs of infection such as redness, pus, swelling, fever.
- advise about safe movement post caesarean section
Diabetic preconception or booking appointment: information sharing
- BGL control and its importance
- strategies for controlling BGL
- insulin demands and expectations
- collaborative referral: transfer
- antenatal colostrum harvesting
- induction of labour
- increased BGL monitoring in labour
- growth chart - scans and fundal height
- folic acid 5mg (NTD)
- consider aspirin and calcium
what is the most common disease that causes hyperthyroidism
Graves disease
manifestations of hyperthyroidism
- increased BMR
- heat intolerance
- weight-loss despite increased appetite
- tachycardia
- irritability
- fatigue
- muscle cramps
untreated hyperthyroidism in pregnancy is associated with?
- pregnancy loss or pre-term birth
- PET
- IUD
- IUGR
- neonatal graves disease
- thyroid storm (crisis)
renal changes in pregnancy
- increased kidney size
- increased GFR
- waste products are cleared more effectively
- increased sodium retention - increased plasma
- activity increases when laying down especially left lateral
acute renal failure
- severely compromised or halted renal function > ischemic nephrons > necrosis
- reversible by dealing with the cause
- if it is pregnancy related it may be due to ; PET, haemorrhage, infection.
chronic renal disease
progressive renal damage as a result of another disease process such as hypertension, diabetes, recurrent infection.
- inability to excrete metabolic wastes (electrolytes, urea, creatinine, acids and bases)
- waste products build > acidosis > affects other organs
- BP^ in attempt to move more blood though kidneys, which causes further damage to the kidneys
renal disease midwifery care:
- PET prophylaxis (aspirin and calcium)
- ensure woman remains primary focus of care
- promote normality
- explanations, reassurance and informed consent
- multi-D care: obstetrics and nephrologist (transfer)
renal lab investigations
- CBC, urea and electrolytes, creatinine, cultures
- MSU - cultures and PCR
complications of a primary herpes infection in pregnancy:
- high risk of miscarriage or preterm birth
- indicated for caesarean section
- primary infection close to vaginal delivery = 57% transmission rate to baby
midwifery actions for herpes
- inspect lesions - take viral swab to confirm
- if active, offer referral for consultation
- offer / prescribe antiviral medication
- discuss birth implications
Hepatitis B symptoms
- fever
- abdominal pain (swollen liver)
- joint pain
- jaundice
midwifery actions and considerations for Hep B
- antiviral med (not prescribed by us) if high viral load
- no FSE or FBS or ARM in labour (open wounds of baby)
- wash baby after birth (before any injections)
- administer immunoglobulin (before BF)
- notify medical officer of health
- educate about breastfeeding - safe if immunoprophylaxis given
transfer categories for Hep B
- chronic or acute, active = consultation
- chronic, active and on immunosuppressants = transfer
what is myasenthia gravis
an auto-immune disease that causes weakness of the skeletal muscle including the face. The first 2 years from diagnosis is usually the worst - not recommended to conceive in this time.
symptoms of MG:
- drooping eyelids
- double vision
- trouble breathing and swallowing
- weak limbs
symptoms of MG are exacerbated by:
- stress
- pregnancy
- thyroid disease
- infection
MG implications for pregnancy:
- increased risk of preterm labour (medication can cause contractions)
- more difficulty in second stage resulting in assisted delivery
- can be passed onto baby - baby has weak muscles - poor feeding.
