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Questions and Answers
How does heparin affect newborns?
How does heparin affect newborns?
- Reduces blood pressure
- Increases heart rate
- Improves skin flexibility
- Causes darkened or nonflexible skin (correct)
Which statement about heparin is true?
Which statement about heparin is true?
- It improves fetal heart rate
- It does not cross the placenta (correct)
- It causes allergic symptoms in infants
- It directly affects the fetus
Which postpartum nursing intervention is aimed at preventing blood clots?
Which postpartum nursing intervention is aimed at preventing blood clots?
- Scheduling Postpartum Checkups
- Prophylactic Antibiotics
- Antiembolic Stockings/IPC Boots (correct)
- Stool Softener
What is a recommended nursing intervention during labor for a patient with extreme heart disease?
What is a recommended nursing intervention during labor for a patient with extreme heart disease?
What is the purpose of promoting rest during labor?
What is the purpose of promoting rest during labor?
What is PPCM (Peripartum Cardiomyopathy)?
What is PPCM (Peripartum Cardiomyopathy)?
Which medication does not cross the placenta and therefore does not have teratogenic effects on the fetus?
Which medication does not cross the placenta and therefore does not have teratogenic effects on the fetus?
Which diagnostic tests are commonly used for monitoring fetal health and ruling out poor placental perfusion during pregnancy?
Which diagnostic tests are commonly used for monitoring fetal health and ruling out poor placental perfusion during pregnancy?
What is the drug of choice for thrombophlebitis and pulmonary embolism before pregnancy?
What is the drug of choice for thrombophlebitis and pulmonary embolism before pregnancy?
What type of patients are usually advised to avoid pregnancy and may be poor candidates due to being in cardiac failure even at rest?
What type of patients are usually advised to avoid pregnancy and may be poor candidates due to being in cardiac failure even at rest?
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?
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?
What is a potential complication of deep vein thrombosis in pregnancy?
What is a potential complication of deep vein thrombosis in pregnancy?
Which of the following symptoms is NOT associated with right-sided heart failure?
Which of the following symptoms is NOT associated with right-sided heart failure?
What preventive measures should be taken during pregnancy to reduce the risk of complications in patients with right-sided heart failure?
What preventive measures should be taken during pregnancy to reduce the risk of complications in patients with right-sided heart failure?
What diagnostic procedure may be used to monitor pulmonary pressure during labor in patients with right-sided heart failure?
What diagnostic procedure may be used to monitor pulmonary pressure during labor in patients with right-sided heart failure?
How does bed rest impact the risk of developing deep vein thrombosis?
How does bed rest impact the risk of developing deep vein thrombosis?
In LMWH pre-pregnancy treatment, why are frequent ABG assessments necessary?
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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