high risk pregnancy factors
adolescents (<18yo); older adults (>35yo), CVD, HTN, CAD, diabetes,
CKD, ESRD, hx. of high risk pregnancy, preeclampsia,
... [Show More] eclampsia, obesity,
maternal abnormalities
which class of heart disease is pregnancy not reccommended?
Class IV
signs of heart disease in pregnant women
palpitations, SOB, lightheadedness, dizziness, weakness, chest pain, nausea,
vomiting, edema, proteinuria
When to call provider after weight gain during pregnancy?
>5lbs in 1 week
cardiac output during pregnancy
increases 30-50%
Ventricular septal defect (VSD)
large hole between two ventricles lets venous blood pass from the right to the left
ventricle
atrial septal defect (ASD)
a hole in the atrial septum that causes blood in the RA and LA to mix
peripartum heart disease
heart disease that occurs with pregnancy; usually right before pregnancy
signs of LSHF in pregnancy (LUNGS)
orthopnea; paroxsymal nocturnal dyspnea (PND)
signs of RSHF in pregnancy (Rest of body)
distended liver & spleen; ascites; peripheral edema
cardiovascular assessment during pregnancy- Assess activity/exercise level
- presence of cough, edema
- Assess vitals
- Assess liver size (RSHF)
- ECG/ECHO
- Assess fetal size, FHR
- labs, urinalysis (proteinuria)
size of babies born to mom's with cardiac issues are typically...
small for gestational age
education for pregnant women with cardiac issues
- healthy diet (DASH)
- healthy lifestyle
- avoid alcohol, smoking
- exercise daily at functional pace, light
- medications (typically labetalol for HTN)
medication given to pregnant women with HTN
labetalol
Labetalol
blocks stimulation of beta1 and beta2 adrenergic receptor sites which decreases
HTN
PO (typically), IV
MAX DOSE 300mg
Contraindicated: asthma, CHF, CVD, ESRD
indications for labetalol
used to decrease hypertension during pregnancy
contraindications for labetalolasthma, CVD, CHF, ESRD
Nifedipine (Procardia)
Calcium Channel Blocker
MOA: blocks calcium transport resulting in inhibition of contraction causing
systemic vasodilatation
used to decrease HTN in pregnancy when labetalol cannot be used
PO ONLY
SE: tachycardia, HA
Nursing interventions for high-risk cardiac pregnancy during antepartum
- promote rest
- promote healthy nutrition
- avoid infection
- education on medications
nursing interventions for high-risk cardiac pregnancy during intrapartum
- reposition to promote adequate blood flow
» avoid lying directly on back
- if epidural: Monitor BP closely
- concern for FVO w/ fluids, monitor for edema, SOB, crackles
- Monitor for pain/stress
- Monitor FHR more frequently to ensure adequate oxygen [Show Less]