NCM 109: Nursing Care of the Pregnant Client - Pregestational Conditions Quiz
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Questions and Answers

Which of the following is a pregestational condition that can affect pregnancy?

  • Rheumatic heart Disease (correct)
  • Polyuria
  • Gestational Diabetes Mellitus
  • Glycosuria

Infants of diabetic women are how many times more likely to be born with heart anomalies compared to others?

  • 2 times
  • 4 times
  • 3 times
  • 5 times (correct)

What is the most frequent type of glycosuria?

  • Glucosuria (correct)
  • Galactosuria
  • Lactosuria
  • Fructosuria

Which of the following is a characteristic of Type 1 diabetes mellitus?

<p>Both b and c (B)</p> Signup and view all the answers

Which of the following is NOT a pregestational condition listed in the text?

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

What is the main reason that, due to insulin insufficiency, serum glucose levels continue to rise in diabetic patients?

<p>Because body cells cannot use the glucose (C)</p> Signup and view all the answers

What is the fasting plasma glucose level that meets the threshold for the diagnosis of diabetes?

<p>140 mg/dl (B)</p> Signup and view all the answers

What type of blood sample is taken 60 minutes after ingesting a 50-g oral glucose load to assess for diabetes?

<p>Venous blood sample (B)</p> Signup and view all the answers

What does the glycosylated hemoglobin measurement reflect?

<p>Blood sugar level over the past 4 to 6 weeks (A)</p> Signup and view all the answers

When should an ophthalmic examination be done during pregnancy for a woman with gestational diabetes?

<p>Once during pregnancy (A)</p> Signup and view all the answers

What is the upper normal level of HbA1c?

<p>6% (B)</p> Signup and view all the answers

In a woman with diabetes, how often should ophthalmic examinations be conducted during pregnancy?

<p>At each trimester (D)</p> Signup and view all the answers

What is the most common medical complication of pregnancy mentioned in the text?

<p>Iron deficiency anemia (B)</p> Signup and view all the answers

What is the main cause of iron deficiency anemia during pregnancy mentioned in the text?

<p>Inadequate supply or low intake of dietary iron (B)</p> Signup and view all the answers

What is the recommended timeframe for administering Rhogam to an unsensitized mother after delivery of an Rh-positive infant?

<p>Within 72 hours (C)</p> Signup and view all the answers

Which of the following is NOT mentioned as a symptom of iron deficiency anemia in the text?

<p>Shortness of breath (B)</p> Signup and view all the answers

What is the characteristic appearance of red blood cells in iron deficiency anemia?

<p>Microcytic (small red blood cells) and hypochromic (less hemoglobin) (C)</p> Signup and view all the answers

Which of the following is NOT mentioned as a potential maternal effect of iron deficiency anemia during pregnancy?

<p>Increased risk of gestational diabetes mellitus (C)</p> Signup and view all the answers

Flashcards

Diabetes Mellitus (DM)

A condition where the body cannot regulate blood sugar levels properly, usually due to insufficient insulin production.

Gestational Diabetes

Diabetes that develops during pregnancy.

Pre-gestational Diabetes Mellitus

Diabetes present before pregnancy.

Insulin

The hormone that enables glucose to enter cells.

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Hyperglycemia

High blood sugar levels.

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Glycosuria

Presence of sugar in the urine. This is a sign of high blood sugar.

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Polyuria

Excessive urination. A symptom of diabetes.

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Type 1 Diabetes (formerly insulin-dependent diabetes mellitus)

Type of diabetes where the body's immune system attacks and destroys the insulin-producing cells in the pancreas.

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Immune-mediated diabetes mellitus

Autoimmune destruction of beta cells in the pancreas.

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Idiopathic Type 1 Diabetes

Type 1 diabetes with no known cause.

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History of Large Babies

Having a history of giving birth to large babies (10 lbs or more).

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Family History of Diabetes

Having a family history of diabetes. This is a risk factor for diabetes.

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High-risk population

Belonging to a population group with a higher risk of diabetes.

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Polycystic Ovary Syndrome (PCOS)

A hormonal disorder with symptoms like irregular periods and excess androgen levels.

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Diagnosis of Diabetes Mellitus

A fasting blood glucose level of 126 mg/dL or above, or a non-fasting blood glucose level of 200 mg/dL or above.

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50-g Oral Glucose Challenge Test

A test used to confirm a diabetes diagnosis.

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Glycosylated Hemoglobin (HbA1c)

Represents the average blood glucose level over the past 4-6 weeks.

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Ophthalmic Examination

An eye exam to check for complications related to diabetes.

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Study Notes

Pregestational Conditions

  • Diabetes Mellitus (DM) affects 3-5% of all pregnancies, either developing during pregnancy (gestational diabetes) or existing before pregnancy (pregestational diabetes mellitus).
  • Insulin enables glucose uptake by body cells; insufficient insulin levels lead to hyperglycemia and glycosuria (presence of reducing sugars in urine).
  • Polyuria (excessive urination) is a symptom of DM.

Classifications of Diabetes Mellitus

  • Type 1 (formerly insulin-dependent diabetes mellitus):
    • Characterized by destruction of beta cells in the pancreas, leading to absolute insulin deficiency.
    • Immune-mediated diabetes mellitus results from autoimmune destruction of beta cells.
    • Idiopathic type 1 refers to forms with no known cause.

Risk Factors for Diabetes Mellitus

  • History of large babies (10 lb or more), unexplained fetal or perinatal loss, congenital anomalies in previous pregnancies.
  • Family history of diabetes (one close relative or two distant ones).
  • Member of a population with a high risk for diabetes (Native American, Hispanic, Asian).
  • History of polycystic ovary syndrome.

Assessment and Diagnosis of Diabetes Mellitus

  • Fasting plasma glucose of 126 mg/dl or above, or non-fasting plasma glucose of 200 mg/dl or above, meets the threshold for diagnosis of diabetes.
  • Diagnosis must be confirmed on a subsequent day using a 50-g oral glucose challenge test.
  • Measurement of glycosylated hemoglobin (HbA) reflects average blood glucose levels over the past 4-6 weeks.

Monitoring a Woman with Diabetes Mellitus

  • Ophthalmic examination: once during pregnancy for gestational diabetes, and at each trimester for women with known diabetes.
  • Rhogam injection within 72 hours of delivery for unsensitized RH-positive mothers.

Anemia

  • Inadequate levels of hemoglobin in the blood (less than 12 gm/dL).
  • Causes: smoking, medication, nutritional deficiency in iron and folic acid during pregnancy.
  • Iron Deficiency Anemia: most common anemia of pregnancy, characterized by microcytic and hypochromic red blood cells.
  • Symptoms: cheilosis, headache, easy fatigability, pica, koilonychia, pallor of skin and mucous membranes, and dizziness.
  • Maternal effects: increased risk of infection, preeclampsia, postpartum hemorrhage, and delayed healing of episiotomy.

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Test your knowledge on pregestational conditions such as Rheumatic heart Disease, Gestational Diabetes Mellitus, Substance Abuse, RH Sensitization, Anemia, DIC, and Pseudocyesis. Understand the implications of these conditions on pregnant clients and their unborn babies.

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