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26 Cards in this Set

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What % of pregnancies are complicated with GDM?
4%
True or False: GDM is more likely to occur in hispanic, native american, asian or african americans.
True
When are most women diagnosed with GDM?
2nd and 3rd trimester when fetal nutrion demands rise, maternal insulin resistance is increased, and maternal insulin demands rise 3x
The woman is flushed, skin is hot she has dry mouth and is excessively thirsty, having rapid deep inspirations what is she exhibiting signs of?
Hyperglycemia
The woman is showing signs of hypoglycemia what would you expect her blood glucose to be?
less than 60 mg/dl
The woman is having shallow respirations, cold and clammy skin, disoriented, with blurry vision what are these symptoms typical of:
hypoglycemia
why does insulin resistance increase?
insulin antagonistic effects of the placental hormones- cortisol and insulinase.
if the woman is diagnosed in the first trimester with GDM what is the main concern?
because the fetus is in critical period of organogenisis congenital anomolies may occur
2 major risks of GDM are:
hypertensive disorders- risk doubles
fetal macrosomia- cesarian, shoulder dystocia and birth trauma.
Fasting glucose is normal but GTT- glucose tolerance test is abnormal. how do you treat the condition?
diet
Abnormal GTT and elevated fasting glucose is controlled by:
insulin
GTT in a low risk woman is done at -----weeks of gestation
24-28
The neonate is at increased risk for what further complications?
hypoglycemia, hypocalcemia, hyperbilirubinemia, thrombocytopenia,polycythemia and respiratory distress syndrome
For the avg woman the glucola test consists of and does the woman have to be fasting?
50 g oral glucose load followed by plasma glucose determination 1 hour later.
what is a positive glucola test?
over 140 mg/dl
T or F: the 3hour OGTT (oral glucose tolerance test) is given routinely at the 24th week office visit.
False: only if the 1hour test is positive. the 3 hour test is given after a 12hour fast and after 3 days of unrestricted diet.
what may give the test a false positive?
caffiene intake
How many of the values have to meet or exceed 'normal' for diagnosis of GDM?
2 of the 4 values have to meet or exceed the norm
The goal of therapy for woman with GDM is strict blood glucose control. what are acceptable levels?
fasting less than 105 mg/dl
2 hrs post-prandial less than 120 mg/dl
what is the diabetic diet?
30-35 kcal/kg of present preg. weight- 2000-2500/day. careful choices of what those calories consist of.
T or F: exercise is instrumental in lowering blood glucose and eliminating need for insulin.
True
how often should Blood glucose monitoring happen in woman diagnosed with GDM?
At least weekly.
What special tests for fetal monitoring are done if mother is on insulin or has other complications such as hypertension or previous still birth?
non-stress test and biophysical profile weekly
during labor and delivery how often is blood glucose level checked? what should it be?
every 2 hours, less than 100mg/dl to minimize risk of hypoglycemia in neonate
when can woman be assessed for glucose levels post-partum?
4-6 weeks or after breastfeeding has stopped.
what is the percentage of recurrance for GDM?
50%