T4 - Medical Disorders Substance Abuse (Josh)

Question 1

How is Heart Disease classified?

Answer 1

Class 1
Class 2
Class 3
Class 4

***classes can change throughout pregnancy

Question 2

Which Heart Disease Classification?

Asymptomatic and has no limitation on activity

Answer 2

Class 1

Question 3

Which Heart Disease Classification?

Symptomatic w/ slight limitation on activity

Answer 3

Class 2

Question 4

Which Heart Disease Classification?

Symptomatic w/ marked limitations on activity.

Answer 4

Class 3

Question 5

Which Heart Disease Classification?

Cardiac insufficiency or angina occurs even at rest

Inability to carry out any physical activity w/out discomfort

Answer 5

Class 4

Question 6

Which Class of Heart Disease will definitely have a C/S?

Answer 6

Class 4

Question 7

When is the greatest risk for the client w/ CHF?

Answer 7

28-32 wks b/c that is when volume peaks

Question 8

Symptoms of CHF

Answer 8

Edema (progresses from pedal to generalized, pitting and pulmonary)

Fatigue

Dyspnea w/ ADL –> orthopnea

Crackles at bases of lungs

Question 9

What is most common CV complication from pregnancy?

Answer 9

CHF

Question 10

What is cardiac decompensation?

Answer 10

inability to maintain adequate CO

Question 11

Why would we give a prophylactic antibiotic for the CV client before invasive procedures?

Answer 11

prevent bacterial endocarditis

Question 12

Why would we be cautious about Diruetics (Furosemide) for CHF client who is pregnant?

Answer 12

may interfere w/ perfusion to baby

Question 13

Iron Deficiency Anemia:

What is total Iron requirement for pregnancy?

Answer 13

1000 mg

Question 14

S/S of Iron Deficiency Anemia

Answer 14

Pallor

Fatigue

Lethargy

HA

Pica

Question 15

Nursing education r/t supplemental Iron

Answer 15

Vit C increases absorption

Milk, Tea and Cofee DECREASE absorption

Question 16

How much Folic Acid needed per day?

Answer 16

4 mg/day

Question 17

When we think of Cocaine, we should think of — —

Answer 17

placental abruption

Question 18

Smoking is a — and can cause a — baby.

Answer 18

vasoconstictor

LBW
- due to poor perfusion

Question 19

When do signs of Heroin withdrawal appear in neonate?

Answer 19

within 72 hrs

Question 20

Client teaching r/t Substance Abuse

Answer 20

Should not go ‘cold turkey’

Heroine addicts may be put on methadone

Question 21

What are our concerns about Stadol for a client who is a heroin addict?

Answer 21

would cause INSTANT withdrawal symptoms

Question 22

Treatment for AIDS during Pregnancy

Answer 22

Zidovudine (ZDV) orally beginning after 14 wks gestation (syrup)

Administered IV during labor

Administered to infant ~6 wks after delivery

Question 23

Amniocentesis for AIDS mom?

Answer 23

NO

Question 24

Interventions during Intrapartum for AIDS mom

Answer 24

Avoid scalp electrodes

Avoid episiotomy

Avoid Pitocin (strong UC can cause vag tears)

ZDV given IV as ordered

Question 25

Neonate and HIV

Answer 25

bathe baby prior to any invasive procedures

ZDV at 6 wks

Question 26

Pregnant client is two times more likely to form — due to increased progesterone.

Answer 26

gallstones

• **antibiotics
• **meperidine or atropine to decrease spasms
• **omit fatty foods

Question 27

What are the TORCH infections?

Answer 27

Toxoplasmosis

Others (Varicella)

Rubella

Cytomegalovirus (Herpes)