Medical Conditions in Pregnancy

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Questions and Answers

Which of the following symptoms is NOT typically associated with hyperglycemia during pregnancy?

  • Nausea
  • Hypoglycemia (correct)
  • Polydipsia
  • Fruity breath

What is the primary reason for conducting a glucose tolerance test during pregnancy?

  • To assess maternal hypertension
  • To determine fetal lung maturity
  • To diagnose gestational diabetes mellitus (correct)
  • To check for iron-deficiency anemia

Which procedure is included in nursing care to assess fetal well-being?

  • Amniocentesis for iron levels
  • Urinalysis for ketones
  • Glucose screening
  • Nonstress test (correct)

Which of the following factors is NOT considered a risk factor for gestational diabetes mellitus?

<p>Gestational hypertension (C)</p> Signup and view all the answers

What test is recommended between 24 to 28 weeks of pregnancy to diagnose potential glucose issues?

<p>Glucose screening (C)</p> Signup and view all the answers

Which condition is characterized by the presence of seizures or coma?

<p>Eclampsia (D)</p> Signup and view all the answers

Which laboratory test is critical for confirming elevated liver enzymes in suspected HELLP Syndrome?

<p>Liver enzyme panel (B)</p> Signup and view all the answers

What finding is least likely associated with severe preeclampsia?

<p>Elevated liver enzymes (A)</p> Signup and view all the answers

Which risk factor for preeclampsia includes maternal age younger than 19 or older than 40?

<p>Maternal age (B)</p> Signup and view all the answers

Which diagnostic procedure is specifically used to assess fetal well-being in pregnant women with complications?

<p>Daily kick counts (A)</p> Signup and view all the answers

Which risk factor is associated with hyperemesis gravidarum?

<p>Maternal age younger than 30 (A)</p> Signup and view all the answers

What is a common laboratory test for diagnosing iron-deficiency anemia?

<p>CBC (B)</p> Signup and view all the answers

Which medication can be cautiously used for hyperemesis gravidarum?

<p>Metoclopramide (A)</p> Signup and view all the answers

What nursing care protocol is essential for a client with hyperemesis gravidarum?

<p>Monitor weight (A)</p> Signup and view all the answers

Which of the following findings is associated with iron-deficiency anemia?

<p>Fatigue and weakness (B)</p> Signup and view all the answers

What dietary recommendation should be made to a client with iron-deficiency anemia?

<p>Consume more iron-rich foods (C)</p> Signup and view all the answers

What is a common complication of gestational diabetes mellitus for the fetus?

<p>Large baby problems (D)</p> Signup and view all the answers

Which laboratory test is used to assess thyroid function in pregnancy complications?

<p>Thyroid test (D)</p> Signup and view all the answers

What is a common finding associated with cervical insufficiency?

<p>Pink-stained vaginal discharge or bleeding (C)</p> Signup and view all the answers

Which of the following is a risk factor for cervical insufficiency?

<p>History of cervical trauma (D)</p> Signup and view all the answers

What is the typical nursing action for a client who has undergone cervical cerclage?

<p>Monitor client reports of pressure and contractions (B)</p> Signup and view all the answers

Which of the following instructions should be included in client education for someone at risk of cervical insufficiency?

<p>Increase hydration (A), Avoid sex during pregnancy (C)</p> Signup and view all the answers

What is the purpose of a prophylactic cervical cerclage?

<p>To prevent premature cervical dilatation (A)</p> Signup and view all the answers

What is one potential consequence of hyperglycemia during pregnancy?

<p>Excessive fetal growth (D)</p> Signup and view all the answers

Which of the following is NOT a symptom of hypoglycemia during pregnancy?

<p>Polyuria (B)</p> Signup and view all the answers

What is a significant finding associated with eclampsia?

<p>Onset of seizures (D)</p> Signup and view all the answers

Which laboratory test is typically performed to monitor glucose levels during pregnancy?

<p>Glucose Tolerance Test (B)</p> Signup and view all the answers

What is one of the main nursing care interventions for managing hyperglycemia during pregnancy?

<p>Monitoring the fetus (B)</p> Signup and view all the answers

Which laboratory test is essential for monitoring suspected HELLP syndrome?

<p>Liver enzymes (B)</p> Signup and view all the answers

Which symptom is most indicative of severe preeclampsia?

<p>Severe continuous headache (C)</p> Signup and view all the answers

Which risk factor is NOT associated with gestational diabetes?

<p>Maternal age of 25 years (B)</p> Signup and view all the answers

What risk factor significantly contributes to the likelihood of developing preeclampsia?

<p>Chronic hypertension (B)</p> Signup and view all the answers

Which of the following findings would cause concern for severe preeclampsia diagnosis?

<p>Proteinuria (C)</p> Signup and view all the answers

Which finding is most indicative of hyperemesis gravidarum?

<p>Excessive vomiting (A)</p> Signup and view all the answers

What is the recommended iron intake for a pregnant woman suffering from iron-deficiency anemia?

<p>27 mg/day (A)</p> Signup and view all the answers

Which laboratory test is least relevant for diagnosing hyperemesis gravidarum?

<p>Hemoglobin A1c (A)</p> Signup and view all the answers

Which of the following is a risk factor for developing iron-deficiency anemia during pregnancy?

<p>Limited dietary iron intake (C)</p> Signup and view all the answers

What is the most appropriate nursing intervention for a pregnant client experiencing hyperemesis gravidarum?

<p>Administer IV fluids (D)</p> Signup and view all the answers

Which of the following dietary recommendations would best support a patient with iron-deficiency anemia?

<p>Eat more legumes and dark leafy greens (C)</p> Signup and view all the answers

What condition can contribute to large baby problems in gestational diabetes mellitus?

<p>Increased insulin from the baby (B)</p> Signup and view all the answers

What medication is commonly recommended for clients with hyperemesis gravidarum to manage symptoms?

<p>Metoclopramide (D)</p> Signup and view all the answers

Flashcards

Severe Preeclampsia criteria

Blood pressure of 160/110 mmHg or higher, accompanied by severe headache, hyperreflexia, and blurred vision.

HELLP Syndrome components

A serious complication of pregnancy characterized by Hemolysis (H), Elevated Liver enzymes (EL), and Low Platelets (LP).

Eclampsia onset

Sudden onset of seizures or coma, often preceded by severe headaches, epigastric pain, and hyperreflexia.

Preeclampsia risk factor: Age

Maternal age younger than 19 or older than 40 increases risk of preeclampsia.

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Preeclampsia risk factor: First pregnancy

First pregnancies have a higher risk of preeclampsia than subsequent pregnancies.

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Gestational Hypertension

High blood pressure (140/90 or higher) that develops for the first time during pregnancy, usually after 20 weeks.

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Preeclampsia

A serious condition associated with gestational hypertension characterized by high blood pressure and other symptoms (headache, edema, irritability, etc.)

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Glucose Screening

A blood test to check for high blood sugar levels, usually performed between 24 and 28 weeks of pregnancy.

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Hyperglycemia

High blood sugar levels during pregnancy.

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Hypoglycemia

Low blood sugar levels during pregnancy.

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Hyperemesis Gravidarum Risk Factors

Conditions that increase the chance of severe pregnancy nausea and vomiting, including younger maternal age, multiple pregnancies, gestational trophoblastic disease, stress, thyroid issues, diabetes, and family history.

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Hyperemesis Gravidarum Findings

Symptoms of severe pregnancy nausea and vomiting, including excessive vomiting, dehydration, weight loss, increased heart rate, decreased blood pressure, and poor skin elasticity.

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Iron-Deficiency Anemia Risk Factors (Pregnancy)

Factors that contribute to low iron levels during pregnancy, such as short intervals between pregnancies, heavy menstrual bleeding, a diet lacking iron, and unhealthy weight loss.

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Iron-Deficiency Anemia Findings

Symptoms of low iron during pregnancy, including fatigue, weakness, and unusual food cravings (pica).

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Gestational Diabetes Mellitus Risk

High risk conditions like large baby problems due to higher levels of insulin produced by the fetus, leading to complications

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Hyperemesis Gravidarum Nursing Care

Nursing care for severe morning sickness, focusing on monitoring fluid intake and output, skin condition, vital signs, and weight, along with recommending a clear liquid diet and NPO until the vomiting ceases.

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Iron Supplements and Absorption

Oral Iron supplements should be taken on an empty stomach & with Vitamin C-rich foods to enhance absorption.

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Gestational Diabetes Mellitus Risks (Fetus)

High risk condition related to potential problems with the size of the baby, due to the baby's body producing higher levels of its own insulin.

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Cervical Insufficiency

A condition where the cervix starts to open (dilate) too early in pregnancy, which can lead to the loss of a pregnancy.

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Cervical Trauma

An injury to the cervix, often from a previous childbirth or surgery, that can weaken the cervix and make it more likely to dilate prematurely.

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Diethylstilbestrol (DES) Exposure

A risk factor for cervical insufficiency where the mother took DES during pregnancy, which can affect the development of the cervix.

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Cervical Cerclage

A procedure where a stitch is placed around the cervix to help keep it closed.

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Cervical Cerclage Removal

The removal of the stitches placed around the cervix, usually between 36 and 38 weeks of pregnancy.

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Hyperemesis Gravidarum

Severe nausea and vomiting during pregnancy, causing dehydration and weight loss.

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Iron-Deficiency Anemia

A condition during pregnancy where low iron levels cause fatigue, weakness, and unusual food cravings (pica).

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Iron-Deficiency Anemia Risk Factors

Factors contributing to low iron during pregnancy, including short intervals between pregnancies, heavy menstrual bleeding, a diet lacking iron, and unhealthy weight loss.

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Iron-Deficiency Anemia Treatment

Treatment includes increasing dietary iron with iron-rich foods and supplements, taking iron on an empty stomach with vitamin C for better absorption, and managing constipation with fiber and fluids.

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Gestational Diabetes Mellitus (GDM)

Diabetes that develops during pregnancy, posing risks to the fetus, especially regarding its size due to increased insulin production.

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GDM Risks to Fetus

Risks associated with GDM include the baby being larger than expected due to increased insulin production, potentially leading to complications.

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Gestational Diabetes: What is the time frame for glucose screening?

Glucose screening is typically done between 24 and 28 weeks of pregnancy.

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Gestational Diabetes: What are the potential problems for the fetus?

Gestational Diabetes can lead to the fetus producing excessive insulin, causing the baby to grow abnormally large. This can increase the risk of birth complications.

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Gestational Diabetes: What are the potential problems for the mother?

Gestational Diabetes can lead to high blood sugar levels, causing potential problems for the mother, including increased risk of preeclampsia, premature labor, and infections.

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Gestational Diabetes: What are some common symptoms in the mother?

Symptoms can include frequent thirst, increased urination, increased hunger, nausea, abdominal pain, dry skin, and a fruity breath odor. These are all related to the body trying to get rid of excess sugar.

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Gestational Diabetes: What is the first-line treatment?

The initial treatment for gestational diabetes is often diet and exercise modification. Insulin therapy may be required if blood sugar levels cannot be controlled with lifestyle changes.

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What are the defining features of Severe Preeclampsia?

Severe Preeclampsia is characterized by blood pressure of 160/110 mmHg or higher, accompanied by severe headache, hyperreflexia (overactive reflexes), and blurred vision.

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What signifies Eclampsia?

Eclampsia is characterized by the onset of seizures or coma, often preceded by severe headaches, epigastric pain (upper abdominal pain), hyperreflexia, and hemoconcentration (thickening of blood).

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What does HELLP stand for in HELLP syndrome?

HELLP syndrome stands for: Hemolysis (breakdown of red blood cells), Elevated Liver enzymes, and Low Platelets.

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What are some risk factors for preeclampsia?

Some risk factors for preeclampsia include maternal age younger than 19 or older than 40, first pregnancy, extreme obesity, multifetal gestations (twins or more), chronic renal disease, chronic hypertension, family history of preeclampsia, diabetes, rheumatoid arthritis, and systemic lupus erythematosus.

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What are some findings associated with preeclampsia?

Some findings associated with preeclampsia include severe continuous headache, nausea, blurred vision, flashes of light or dots before the eyes, hypertension, proteinuria, periorbital, facial, hand, and abdominal edema, pitting edema in lower extremities, vomiting, oliguria (reduced urine output), hyperreflexia, scotoma (blind spots), epigastric pain, right upper quadrant pain, seizures, jaundice, diminished breath sounds, and dyspnea.

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Study Notes

Cervical Insufficiency

  • Expulsion of the products of conception occurs due to premature cervical dilation
  • Risk Factors: History of cervical trauma, in utero exposure to diethylstilbestrol, or exposure during pregnancy
  • Findings: Pink-stained vaginal discharge or bleeding, possible fluid gush, uterine contractions with expulsion of the fetus, postoperative cerclage monitoring, contractions, rupture of membranes, and infection manifestations
  • Diagnostic and Therapeutic Procedures: Ultrasound, prophylactic cervical cerclage.
  • Nursing Care: Evaluate and support the client; assess vaginal discharge; monitor client reports of pressure and contractions; check vital signs.
  • Client Education: Adherence to activity restrictions, increased hydration, avoidance of sex, monitoring of cervical/uterine changes; cervical cerclage placement at 12-14 weeks, bed rest
  • Health Promotion and Prevention: Report findings, preterm labor, rupture of membranes, infection, strong contractions (less than 5 minutes apart), severe perineal pressure, and urge to push to the provider, follow up for observation, and plan for cerclage removal between 36 and 38 weeks

Hyperemesis Gravidarum

  • Risk Factors: Maternal age under 30 and multifetal gestation
  • Findings: Excessive vomiting, dehydration, weight loss, increased pulse rate, decreased blood pressure, and poor skin turgor.
  • Lab Tests: Urinalysis, chemistry profile, thyroid tests, and CBC
  • Nursing Care: Monitor intake and output, assess skin turgor, monitor weight, vital signs, and client needs for temporary nothing-by-mouth (NPO) status until vomiting stops.
  • Medications: IV fluids, pyridoxine (vitamin B6), and other vitamins as tolerated; use antiemetic medications (metoclopramide) cautiously.
  • Client Education: Advanced diet (clear liquids first, then solids as tolerated), enteral nutrition support for severe cases.

Iron-Deficiency Anemia

  • Risk Factors: Less than two years between pregnancies, heavy menses, diet low in iron, and unhealthy weight loss programs.
  • Findings: Fatigue, weakness, cravings for unusual foods (pica)
  • Lab Tests: Hemoglobin (Hgb) and Hematocrit (Hct)

Gestational Diabetes Mellitus

  • Risks to Fetus: Large baby problems (baby produces higher levels of insulin); blood sugar low; infections (UTI, vaginal); hydramnios; ketoacidosis; increased insulin resistance, and hypoglycemia/hyperglycemia which causes fetal growth excessively.
  • Risk Factors: Obesity, hypertension (HTN), glycosuria, maternal age other than 25, family history, and previous large or stillborn infants.
  • Findings: Hypoglycemia (nervousness, headache, weakness, irritability, hunger, blurred vision); hyperglycemia (polydipsia, polyphagia, polyuria, nausea).

Gestational Hypertension

  • Findings: Abdominal pain, flushed dry skin, and fruity breath.
  • Lab Tests: Glucose screening (24-28 weeks); glucose tolerance test (fasting, 100g glucose load).
  • Procedures: Biophysical profile, amniocentesis, non-stress test.
  • Nursing Care: Blood glucose monitoring, diet and exercise (insulin may be needed if glucose levels remain high), daily kick counts, and self-administration of insulin
  • Preeclampsia: Blood pressure 140/90 mmHg or higher on two separate occasions at least four hours apart, headaches, irritability, and edema.
  • Severe Preeclampsia: Blood pressure 160/110 mmHg or higher; severe headaches, hyperreflexia, blurred vision; eclampsia (onset of seizures or coma)
  • HELLP syndrome: Hemolysis, elevated liver enzymes, and low platelets.

Other Medical Conditions (from pages 4 & 5)

  • Low Platelets (LP): Risk factors include maternal age under 19 or over 40, first pregnancy, extreme obesity, multifetal gestation, chronic renal disease, chronic hypertension, family history of preeclampsia, diabetes, rheumatoid arthritis, and systemic lupus erythematosus. Findings include severe continuous headache, blurred vision, flashes of light, periorbital/facial/hand/abdominal swelling, vomiting, oliguria, hyperreflexia, scotoma, epigastric pain, RUQ pain, seizures, jaundice, dyspnea, and diminished breath sounds. Testing includes liver enzymes, blood creatinine, BUN, uric acid, CBC, and clotting studies; diagnostic procedures include urine dipstick testing for proteinuria, 24-hour urine collection, non-stress test, contraction stress test, biophysical profile, and Doppler blood flow assessments.

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