Podcast Beta
Questions and Answers
How does heparin affect newborns?
Which statement about heparin is true?
Which postpartum nursing intervention is aimed at preventing blood clots?
What is a recommended nursing intervention during labor for a patient with extreme heart disease?
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What is the purpose of promoting rest during labor?
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What is PPCM (Peripartum Cardiomyopathy)?
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Which medication does not cross the placenta and therefore does not have teratogenic effects on the fetus?
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Which diagnostic tests are commonly used for monitoring fetal health and ruling out poor placental perfusion during pregnancy?
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What is the drug of choice for thrombophlebitis and pulmonary embolism before pregnancy?
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What type of patients are usually advised to avoid pregnancy and may be poor candidates due to being in cardiac failure even at rest?
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In the classification of heart disease for 30-32 weeks of pregnancy, which class experiences ordinary physical activity causing excessive fatigue, palpitation, dyspnea, or anginal pain?
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What is a potential complication of deep vein thrombosis in pregnancy?
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Which of the following symptoms is NOT associated with right-sided heart failure?
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What preventive measures should be taken during pregnancy to reduce the risk of complications in patients with right-sided heart failure?
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What diagnostic procedure may be used to monitor pulmonary pressure during labor in patients with right-sided heart failure?
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How does bed rest impact the risk of developing deep vein thrombosis?
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In LMWH pre-pregnancy treatment, why are frequent ABG assessments necessary?
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Study Notes
Right-Sided Heart Failure
- Includes pulmonary valve stenosis, Eisenmenger syndrome, and right-to-left atrial/ventricular septal defect
- Symptoms: AWHEAD
- A: Anorexia and Nausea due to venous engorgement and venous stasis within abdominal organs
- W: Weight Gain due to fluid retention
- H: Hepatomegaly due to venous engorgement of the liver
- E: Edema, particularly in the feet and ankles, worsens with prolonged standing/sitting
- A: Ascites, fluid accumulation in the peritoneal cavity due to pressure in portal vessels
- D: Distended Jugular Vein due to venous pressure
Preventive Measures
- For pregnant women: acquire oxygen administration and frequent ABG assessments, hospitalization for at least some days during the last part of pregnancy
- During labor: pulmonary artery catheter inserted to monitor pulmonary pressure, close monitoring after epidural anesthesia to minimize risk of hypotension
Nursing Interventions
- Promote rest
- Promote healthy nutrition
- Educate on avoidance of infection
- Be prepared for emergency actions
- During labor: frequently assess vital signs, fetal heart rate, and uterine contractions
- Best position: side-lying, except for pulmonary edema, use Semi-Fowler's position to ease breathing
Postpartum Nursing Interventions
- Anti-embolic stockings/Intermittent Pneumatic Compression (IPC) boots
- Prophylactic antibiotics
- Stool softener
- Agents to encourage uterine involution (oxytocin/Pitocin) to regulate blood pressure
- Schedule postpartum checkups
- Monitor for Peripartum Cardiomyopathy (PPCM)
Classification of Heart Disease
- Class I: Uncompromised, normal pregnancy and birth
- Class II: Slightly compromised, ordinary physical activity causes discomfort
- Class III: Markedly compromised, complete bed rest required
- Class IV: Severely compromised, poor candidates for pregnancy, avoid pregnancy
Peripartum Cardiomyopathy (PPCM)
- Extremely rare condition originating in pregnancy
- Difficulty meeting oxygen and nutritional requirements for mother and fetus
- Drug of choice: Low-Molecular Weight Heparin (LMWH) Enoxaparin
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Description
Explore the signs and symptoms of right-sided heart failure with mnemonics to remember key indicators like anorexia, weight gain, hepatomegaly, edema, and more. Understand conditions such as pulmonary valve stenosis, Eisenmenger syndrome, and right-to-left atrial/ventricular septal defect.
