NR 327(NR 327) Pregnancy complications part 1 (2) Final Exam 2022/2023: NSG 211(NSG 211) Maternity Nursing: NSG 4052 (NSG-4052) Community Health Nursing:
... [Show More] With Complete Solutions (Chamberlain College of Nursing)
Pregestational diabetes {{Ans- Diabetes that existed before pregnancy
Gestational diabetes {{Ans- glucose intolerance develops during pregnancy
When does gestational diabetes resolve? {{Ans- postpartum
What % of those with gestational diabetes will develop DM later in life? {{Ans- 70%
What age is a RF for GDM? what ethniticty? what family Hx? what number of gestations? what health status? {{Ans- 1. >25
2. AA
3. fam hx of diabetes
4. mult gestations
5. obesity
What past obstetrical hx = RFs for GDM? {{Ans- 1. GDM in prev pregnancies
2. hx of infant >4000g
3. repeated spontaneous abortions
4. H/O unexplained stillbith
What is the pathophys of GDM? {{Ans- maternal insulin resistance undiagnosed beta cell dysfunction is exacerbated by human placental lactose (hPL)
What other than hPL exacerbates maternal insulin resistance and beta cell dysfunction? {{Ans- growth hormone and corticotropin releasing hormone
What produces hPL? {{Ans- the enlarging placenta
What does hPL promote? {{Ans- lipolysis with increased levels of circulating fatty acids which causes decrease in glucose uptake
hPL is anti what {{Ans- anti-insulin
what does maternal insulin resistance allow for the baby {{Ans- increased glucose availability for the growing fetus
what are complications to the fetus from GDM? {{Ans- 1. 6 fold increase in congenital anomaly
2. intrauterine demise or stillbirht
3. spontaneous abortion
what are the 4 mc deformities in fetus from GDM? {{Ans- 1. cardiac
2. CNS
3. Renal
4.limb deformities
What is macrosomia? {{Ans- A high-birthweight infant
what weight is macrosomia? {{Ans- >4000g
what does macrosomia >4000g increase risk of? {{Ans- 1. C-section
2. PPH
3. vaginal lacerations
4. shoulder dystocia
5. low Apgar score
6. hypoglycemia
7. obesity later in later
can glucose cross the placenta? what does this mean for the fetus? {{Ans- yes so the higher the maternal glucose, the higher the fetal glucose level
IUGR {{Ans- intrauterine growth restriction
what defines IUGR? what causes it? what is the issue with it? {{Ans- weight less than the 10th percentile from utter-placental defciency and it increases morbidity and mortality
What is Polyhydramnios (hydramnios)? {{Ans- Too much amniotic fluid (>2L) or 2000mL
what results from too much amniotic fluid in polyhydramnios? {{Ans- 1. increased uterine size and fluid = placental abruption
2. preterm labor
3. uterine atony
what causes neonatal hypoglycemia? {{Ans- sudden change in maternal-fetal glucose balance
what is an increase in maternal glucose crossing the placenta countered by {{Ans- countered by increase in fetal production of insulin
when the maternal supply of glucose is removed, higher insulin causes what {{Ans- neonatal hypoglycemia
what can neonatal hypoglycemia result in? {{Ans- 1. delayed fetal lung maturity
2. neonatal hypocalcemia, hypoagnesemia and hyperbilirubinemia
what are moms with pregestatonal diabetes at higher risk of? {{Ans- DKA esp if have T1DM
when will moms with pregestaional diabetes experience hypoglycemia and what sxs with it {{Ans- early causing N/V
how Is pregestation diabetes related to BP {{Ans- can cause preeeclampisa and high HTN
why do those with pregestational diabetes have more UTIs and peylonephritis? {{Ans- because the glucose in urine makes a good place for bacteria to grow
what happens with diabetic retinopathy and nephropathy in pregestation diabetes {{Ans- both worsen
when to do fetal US? {{Ans- early US for viability at weeks 8-12 then comprehensive at 18-20weeks
when do fetal kicks start {{Ans- 26-28weeks
how many fetal kicks should be felt per hour {{Ans- 10 per hour
when To give nonstress test, biophysical profile and contraction stress test? {{Ans- 32-34 weeks
who is at high risk of gestational diabetes {{Ans- 1. prior pregnancy with GDM
2. prior macroscomia
3. DMI >30
4. prediabetes
5. prior bariatric surgery
6. glucose challenge test
when to check gestational diabetes {{Ans- at 24-28 weeks
what is the gold standard to chest for gestation diabetes? {{Ans- 100gram 3 hour GTT
see side 67
(>140?)
when is the 50g 1 hour Gluc challenge test + for GDM? {{Ans- if >130-140 [Show Less]