Unit 9: Nursing Care of High Risk antepartal, intrapartal, and postpartal periods
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Created by:
prcooley on December 12, 2010
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Classes:
Childbearing Family Dr. T, West Penn Class of 2011
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55 terms
Terms | Definitions |
|---|---|
 main causes of mortality | hemorrhage, hypertension, infection |
| high risk age | Greater than 35, less than 16 |
| high risk age risks for | pre-term labor, low birth weight baby, cephalopelvic disproportion (cpd) |
| conception within 3 months | may lead to complications because site has not fully healed, if on same side |
| 6 pre-existing medical conditions | htn, asthma, dm, thyroid, pulmonary, renal |
| abnormal presentations | breech, acromion (shoulder) |
| pre-term | less than 37 weeks |
| post-term | more than 40 weeks |
| fetus produces insulin | 10 weeks |
| sign of diabetogenic effect | decreased tolerance to glucose |
| sign of diabetogenic effect | increased insulin |
| sign of diabetogenic effect | increased hepatic glucose production |
| sign of diabetogenic effect | increased glycogen stores for placental needs |
| sign of diabetogenic effect | increase in GFR, and increase in glycosuria |
| Lispro | rapid and intermediate, good for pregnant patients |
| Normal pregnant A1C | 5-6% |
| is associated with malformations | A1C greater than 10% |
| PG (phosphatadylglycerol) | best indicator of lung maturity, a component of surfactant |
| LS | component of surfactant should be 2:1, diabetic ratio 3:1 |
| placental insufficiency | IUGR (inter uterine growth restriction) |
| an effect of diabetes on fetus | increased bilirubin, secondary to hypoxia, polycythemia |
| effect of diabetes on mother | hydramnios (excessive amniotic fluid), pre-eclampsia, infections, spontaneous abortion |
| dystocia | prolonged or difficult labor |
| induction of c-secion | polyhydramnios or macrosomia |
| insulin returns to normal | 7-10 days after delivery |
| breastfeeding calories | need extra 500 to 800 kcal from prepregnant state |
| how is gestational diabetes usually discovered | during a urine dipstick for glucose and protein |
| NYHA stage 1 of heart failure | no limitation of physical activity |
| NYHA stage 2 of heart failure | slight limitation of physical activity. ordinary physical activity results in fatigue, palpitation, or dyspnea |
| NYHA stage 3 of heart failure | marked limitation of physical activity. comfortable at rest, but less than ordinary activity causes fatigue, palpitations, or dyspnea |
| NYHA stage 4 of heart failure | unable to carry out any physical activity without discomfort, have symptoms at rest. |
| cardiac output and volume increase | between 28-34 weeks of pregnancy |
| Cardiac disease during pregnancy can cause | maternal chf |
| Cardiac disease during pregnancy can cause | spontaneous abortion |
| Cardiac disease during pregnancy can cause | preterm labor (ptl) |
| Cardiac disease during pregnancy can cause | maternal and fetal hypoxia |
| Cardiac disease during pregnancy can cause | dysrhythmias |
| Cardiac disease during pregnancy can cause | inter uterine growth restriction |
| mitral valve prolapse | will have systolic murmur, use antibiotics as needed |
| heparin | does not cross the placental barrier |
| coumadin | don't take, category X drug, has a teratogenic effect |
| closed glottis pushing | don't do this, (also known as valsalva) |
| hyperemesis | pernicious, prolonged vomiting, lasts beyond 1st trimester. |
| hyperemesis | treat with b6, vitamins, chamomile, tea, check weight, may use tpn, zofran, compazine, tordol |
| polyhydramnios | 2000 ml (1000 more than normal). |
| polyhydramnios | seen in multiples, diabetes, RH sensitive |
| polyhydramnios | difficult to palpate fundus, increase risk for cord prolapse, risk of malpresentation |
| olighydramnios | less than 300 ml of amniotic fluid |
| olighydramnios | IUGR, renal and urinary malformations and PPROM |
| monozygotic | identical, 1 egg, 2 chorioinic, 2 amnios |
| dizygotic | two of everything, simple as brother and sister |
| shortening | >30 mm is good, less is bad and predisposition for ptl |
| funneling | internal os dilating, shaped like a funnel, amniotic sac funels into the internal os of the cervix |
| tocolytics | stop contractions, mag sulfate, terbutaline |
| funneling | can use sutures on the cervix, but must be removed during delivery |
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