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Maternal NUR259 > Week 2 > Flashcards

Week 2 Flashcards

1
Q

Definition of Gestational Diabetes Mellitus

A

Any degree of glucose intolerance that has its onset or is first diagnosed during pregnancy.

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2
Q

Modifiable risk factors for gestational diabetes?

A

BMI >29, high dietary fat intake, and low levels of physical activity.

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3
Q

Maternal risks with diabetes

A
  • Hydramnios: increase in the volume of amniotic fluid. Thought to be due to excessive fetal urination. May result in premature rupture of membranes.
  • Preeclampsia/eclampsia: occurs more often in diabetic pregnancies, especially when vascular changes occur.
  • Hyperglycaemia: insufficient amounts of insulin can lead to ketoacidosis as ketone bodies rise and are released into the blood.
  • Retinopathy
  • Increased risk of vaginitis and UTIs because of increased glycosuria, creating a favourable environment for bacteria.
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4
Q

Fetal Risks with diabetes

A
  • Macrosomia (large for gestational age (LGA))
  • Sacral agenesis: sacrum and lumbar spine fail to develop
  • Respiratory distress syndrome due to high levels of fetal insulin which inhibit enzymes for surfactant production.
  • Intrauterine growth restriction: due to vascular changes in the mother decrease efficiency of placental perfusion.
  • Hyperbilirubinemia: immature liver enzymes to metabolise the increased bilirubin from polycythemia.
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5
Q

What is the key point in the care of the pregnant woman with diabetes?

A

Scrupulous maternal plasma glucose control. Home monitoring, multiple daily insulin injections and a healthy diet.

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6
Q

What is the most common types of anaemia?

A
  1. Iron deficiency anaemia.
  2. Folic acid deficiency.
  3. Sickle cell disease.
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7
Q

Signs of anaemia?

A

• Fatigue • pallor • lack of energy

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8
Q

Treatment of hyperemesis gravidarum is aimed at:

A

• Controlling the vomiting • Correcting fluid and electrolyte imbalance • Correcting dehydration • Improving nutritional status.

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9
Q

Calculation of the due date?

A

From the 1st day of the last period, subtract 3 months and add 7 days (Nagele’s Rule).

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10
Q

Size of pre-pregnant uterus and pregnant one

A

Pre: 7.5 x 5 x 2.5 (60 g). Pregnant: 28 x 24 x 21 (1100 g). Capacity goes from about 10 mL to 5000 mL.

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11
Q

Identify 4 common discomforts from pregnancy

A
  1. N&V 2. Varicose veins & haemorrhoids 3. Tiredness 4. Urinary frequency
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12
Q

3 possible causes of bleeding during pregnancy

A
  1. Ectopic pregnancy
  2. Threatened spontaneous abortion
  3. Cervical insufficiency
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13
Q

Risks associated with obesity in pregnancy

A
  • Maternal mortality • Preeclampsia
  • Gestational diabetes mellitus
  • Thromboembolism • PPH
  • Increased rate of caesarian birth
  • Greater likelihood of lifelong obesity in offspring
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14
Q

Important minerals during pregnancy

A
  • Calcium and phosphorus

* Iodine • Sodium • Zinc • Magnesium • Iron

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15
Q

Food choices providing Iron

A
  • Lean meats • dark green leafy vegetables

* eggs and • whole-grain, enriched breads and cereals.

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16
Q

Food choices providing Calcium

A
  • 4 cups of milk or equivalent dairy alternative

* Legumes • Nuts • Dried fruits • Dark green leafy vegetables

17
Q

Food choices providing Phosphorus

A

Daily requirement is easily supplied through calcium and protein-rich foods

18
Q

Food choices providing Iodine

A

Iodized salt

19
Q

Food choices providing Sodium

A

Season to take during cooking but avoid providing table salt.

20
Q

Food choices providing Zinc

A

Meats, shellfish, poultry, whole grains, and legumes

21
Q

Food choices providing Magnesium

A

• Milk • whole grains • dark green vegetables • nuts • legumes

22
Q

Magnesium aids in

A

• Cellular metabolism • Bone mineralisation

23
Q

Iron aids in the

A
  • Oxygen-carrying capability of blood

* Expansion of maternal blood volume

24
Q

<p>Calcium and phosphus aid the</p>

A

<p>&bull; Mineralisation of fetal bones and teeth &bull; Acid-base buffering</p>

25
Q

Iodine is an

A
  • Essential part of thyroxine

* Deficiency can lead to cretinism

26
Q

Maternal urinalysis

Presence of protein could mean:

A

Pre-eclampsia or contamination by the liquor fluid.

27
Q

Maternal urinalysis

Presence of glucose could mean:

A

Diabetes

28
Q

Maternal urinalysis

Presence of ketones could mean:

A

Maternal starvation as there is not enough glucose to produce energy and body fats are broken down instead leading to metabolic acidosis reducing the contractibility of the uterus - prolonging labour.

29
Q

Maternal urinalysis

Presence of blood could mean:

A

UTI or obstructed labour

Maternal NUR259 (6 decks)

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