Blueprint for OB Test 2
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| Common signs and symptoms of iron-deficiency anemia in the pregnant woman are | tachycardia, tachypnea, dyspnea, pale skin, low BP, heart murmur, headache, fatigue, weakness, and diszziness. Pica, and pagophagia are also associated with SEVERE iron-deficiency anemia.
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| Anemia during pregnancy is indicated by hemoglobin levels less than | 10 g/dL
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| Nursing care for iron-deficiency anemia during pregnancy | Counseling, Vitamin C enhances and folate, Iron supplements predispose to constipation, support and teaching, adequate fluid intake and rest are important.
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| Treatment for iron-deficiency anemia during pregnancy | diet rich in iron and folate in addition to iron and folate supplementation. Folate increases the effectiveness of Iron therapy. Rarely is a blood transfusion needed.
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| What medication cannot be continued during pregnancy? | Coumadin
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| C-Section during genital warts | Should be done anytime, not just during outbreaks. Baby is always at risk for getting it transmitted.
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| Treatment of Asthma during pregnancy | Mgmt of acute exacerbation, inhalers used for treatment, labor and birth mgmt, will have to alter med management
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| Why would you alter asthm med mgmt during pregnancy? | Some cross the placental barrier
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| Nursing care for asthma during pregnancy | Teaching is a major role, smokking cessation and control of the environment
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| Because the pregnant woman has increased iron requirements, she is particularly vulnerable to | iron-deficiency anemia
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| Pregnant women with a poorly controlled asthma experience a higher incidence of | preeclampsia-eclampsia, hemorrhage, premature labor, respiratory failure, and death.
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| If asthma is well controlled throughout pregnancy, perinatal outcomes are similar to those | of the general population.
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| epilepsy is | a group of neurologic disorders that involve a long-term tendency to have recurrent unprovoked seizures
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| Treatment for epilepsy during pregnancy | current recommendations are for the woman to remain on the drug that most effectively controls her seizures (typically does not cross barrier)
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| Nursing care of status epilepticus during pregnancy | teach importance of carefully following her treatment regimen, eating a diet high in folic acid and of taking folic acid supplements, provide emotional support during prenatal testing for fetal anomalies.
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| Toxoplasmosis is acquired from | litter boxes
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| TORCH stands for | Toxoplasmosis, Other infections (Hep B, Syphilis, Varicella, Herpes Zoster), Rubella, Cytomegalovirus, Herpes Simplex Virus
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| Chlamydia | Most common STI in the US, untreated increases the risk of contracting HIV/AIds
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| The major risk to the pregnancy during seizure results from | blunt trauma. Trauma can lead to miscarriage, premature rupture of membranes, and placental abruption.
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| This is highly recommended for the woman with epilepsy wishing to become pregnant | preconception care
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| The physician may try to wean the woman from the AED because they are typically the cause of these fetal defects | clept lip and palate and cardiac, urinary tract, and neural tube defects comprise the majority of malformations
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| The physician advises the woman to wait at least how long after seizures are under control before trying to become pregnant | 6 months
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| AEDs increase the risk for neural tube defects so she should receive a high dose of | folate supplementation in the 1-3 months preceding and throughout pregnancy
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| Status epilepticus is an emergency complication of epilepsy whereby | seizure activity continues for 5-30 minutes or more after treatment is initiated or when three or more seizures occur without full recovery between seizures.
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| Blood work for seizures includes | glucose, electrolytes, CBC, AED levels, and blood and urine tox screens.
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| The physician starts 2 iv lines post-status epilepticus to allow for iv admin of | benzos such as diazepam or lorazepam
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| Advice for the epileptic pregnant woman | Eat a diet high in folic acid. Also plenty of rest and sleep and to exercise regularly.
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| Sleep on what side during pregnancy? | Left
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| Assessment for TORCH History: | flulike symptoms, fatigue, cat exposure, genital lesions, rash, exposure to sick children.
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| Assessment for TORCH Physical Exam: | lymphadenopathy, headache, malaise, jaundice, NV, low-grade temp, rash, ulcerated and painful lesions of the genitals
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| Assessment for TORCH Psychosocial: | Fear, anxiety, apprehension
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| Diagnostics for TORCH | Serologic Tests: TORCH screen, CBC< HBsAg and HBeAg, Liver function tests; Cultures: CMV, HSV; Pap smear; Serial ultrasounds (monitor for IUGR and other defects throughout preg)
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| Interventions for TORCH | Instruct woman regarding specifics of the infection, transmission, and meds and med mgmt; Reinforce importance of hand washing; encourage questions; suggest a multidisciplinary conference with family members; encourage breast feeding
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| S/S of Toxoplasmosis: | chorioretinitis, intracranial calcification, and hydrocephalus in the newborn
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| toxoplasmosis is difficult to diagnose because it rarely produces symptoms in the woman. It is particularly harmful if the fetus contracts the parasite between | 10 and 24 weeks of pregnancy
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| Treatment of Toxoplasmosis | spiramycin, pyrimethamine, and sulfadiazine.
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| The woman with toxoplasmosis also takes folinic acid to prevent | bone marrow suppression.
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| Perinatologist | Treats mother and baby during and after pregnancy
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| neonatologist | treats only the baby after it's been born
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| Selected risk factors for Gestational Diabetes Mellitus | History of a large-for-gestational age infant, history of GDM, previous unexplained fetal demise, advanced maternal age (>35years), Family history of Type 2 diabetes or GDM, Obesity (>200lb), Non-caucasian ethnicity, FBG >140, RBG >200
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| The woman with Type 1 DM | Fetal surveillance, Diet, Exercise (with approval), Insulin therapy
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| The woman with GDM | Fetal Surveillance, Sometimes insulin, exericise, diet.
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| It is important to monitor fetal growth because macrosomia occurs more commonly in women with | Gestational DM. Conversely, for the woman with longstanding DM or vascular disease, the fetus may be growth restricted.
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| Nursing Process Implementation for the pregnant wioman with DM | Monitor mgmt of therapeutic regimen, Monitor for and prevent infection, Monitor fetal status
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| Gonorrhea | Second in prevalence, Resistant to antibiotics, Can leave the woman infertile or susceptible to ectopic pregnancy because of scarring in the reproductive tract.
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| Human papillomavirus | Most common viral STI in the US, Has a tendency to increase in size during pregnancy, Neonatal HPV infection can result in life threatening laryngeal papillomas. Causes Cervical Cancer
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| Trichomoniasis | Associated with adverse pregnancy outcomes, infections diseases, White milky discharge from Males - female has funky crotch stink.
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| HIV/AIds | Very important for the practitioner to know the pregnant womans HIV status
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| 2 main goals of treatment for the pregnant woman with HIV | Prevent progression of the disease in the woman, Prevent perinatal transmission of the virus to the fetus.
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| Transmission of HIV to the baby can occur | during birth or during breast feeding
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| Treatment of women with IPV | routine screening of all women is the key to assisting those who are ready to report abuse and receive help; interventions for the victim of IPv are directed toward safety assessment and planning.
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| Be careful to only respond to the IPV victim only with | supportive statements
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| Adolescent pregnancy issues | many pregnant teens seek late prenatal care, may be fearful of disclosing pregnancy
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| Treatment for teen pregnancy | prevention. advocacy. help them develop a support network.
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| Nursing care for teen pregnancy | Care for developmental needs, adequate nutrition is essential, care for emotional and psychological needs, Be knowledgeable about community resources
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| Pregnancy Later in life nursing care | approach with an open mind, may feel they have "too much" med info and feel overwhelmed, good skin care.
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| Hyperemesis Gravidarum | Disorder of early pregnancy characterized by severe nausea and vomiting, results in weightloss, nutritional deficiencies, and or electrolyte and acid/base imbalalce
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| Hyperemesis Gravidarum most often appears between | 8 and 12 weeks and usually resolves by week 20
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| Exact cause of Hyperemesis gravidarum is | unclear
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| Risk of hyperemesis is increased with | multiple gestations, molar pregnancy, history of hyperemesis gravidarum, stress and psycho factors can contribute
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| Molar Pregnancy | mimics pregnancy. Is not actual pregnancy. Best indicator of hyperemesis gravidarum.
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