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24 Cards in this Set
- Front
- Back
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Effects of Insulin Secretion During Pregnancy:
~Early Part v/s Late part of Pregnancy? |
Early: reduced amt of insulin secretions
Later: increased amt of insulin |
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Effects of hormones in glucose Utilization:
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-high BMR -N/V
-Rapid fetal growth -increased cell resistance to insulin |
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Gestational diabetes:
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•Diagnosed At 24-28 weeks
•BS 140 mg or > 50 Gm OGTT •Diet Controlled •Insulin IF Poorly Controlled •Tight BG Control – 120 mg/dl •Risk To Develop Type II |
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Management for gestational/ IDDm?
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educate about nutrition.
Eat small meals and snacks. Low fats, increased fiber decreases postprandial hyperglycemia and lowers insulin need. Educate about exercise. |
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s/s of shock?
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decrease b/p
increase pulse pale decrease LOC |
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Gestional/ IDDM illnesses involve medications. How is the administration of these drugs managed by the medical doctor and the OB practitioner?
Page 543 therapeutic management. |
Insulin – early in pregnancy – a woman w/ diabetes may need < insulin than before preg b/c the fetus is using so much glucose for rapid cell growth. Later she will need an increased amt b/c her metabolic rate & need increase. Women with gestational diabetes will be started on insulin therapy, if diet alone is unsuccessful in regulating glucose values. The type of insulin chosen is usually short acting insulin combined with an intermediate type. 2/3 for morning and 1/3 for evening. This is self administered before breakfast ina 2:1 ratio. Human insulin is recommended becaue of antibody response in beef or pork. Women should eat almost immediately after injecting. Oral hypoglycemia agents are not used for regulation during pregnancy because they cross the placenta and are teratogenic to fetus.
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plant cuticle
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very thin film covering surface of plant
protects leaf from moisture loss |
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Tx for Pneumonia – .
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528 top of page – oxygen and antibiotic
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Which med is given 1st for resp d/o?
antiinflammatory or bronchodilator? |
1st: Bronchodilator (tachycardia, restless: sx if toxic)
2nd: antiinflammatory |
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Drugs given for TB?
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-INH w/ B6
*Rifampin (urine: bright orange) -Ethambutol (ALL 3 drugs are given together) |
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Drugs for Asthma:
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The inhaled corticosteroids beclomethasone (Beclovent, Vancenase) and budesonide (Pulmicort, Rhinocort) are commonly used by women with persistent asthma and are also good choices for pregnant women . Beta adrenergic agonist such as terbutaline and albuterol can be taken.
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Drug for Cardio:
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beta blockers and ace inhibitors to reduce blood pressure. Methyldopa is the typical drug described.
Page 518 bottom of page – digoxin: improves the contractions of the heart, adenosine, beta blockers and angiotension converting enzyme during pregnancy, nitroglycerine for angina. Penicillin is acceptable for rheumatic fever clients and is prescribed during pregnancy to keep infection downs because of the cardiac overload. |
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Can Not give ________ if HR is below ______
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Lanoxin
60 |
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PCN is given for ?
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as a prophylactic for Subbacterial endocarditis
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Anticoagulants:
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heparin
lovonox |
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Venous Thromboembolic disease:
The Triad Cascade for Disaster(Pulmonary embolism): |
1. estrogen:
2. blood vessel damage 3. stasis or pooling of blood All 3 contributes for the formation of venous thromboemboic disease |
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Identify the priority nursing care for pregnant clients with cardiovascular disease?
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-Promote lots of rest – (KIM) -
-O2 demand and cardiac workload -Should exercise be limited (Type III/IV) -Promote healthy nutrition - ? Na amt(limit intake, good for electrical impulses & mvmt of water) Educate-Medication – Digoxin, Anticoagulants,Anti arrythmic, Penicllin Educate prevention of Infection Monitor for s & s of cardiac decompensation ( fluid overload + overworked heart – LV) |
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What is the nursing interventions for a pt with a neg Homan's sign?
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Ambulate ASAP
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What is the best management for Sickle cell Anemia in order to improve tissue perfusion?
Page 523 second column midd of page. Interventions include |
periodic exchange transfusions to replace sickle cells with non sickled cells, -an exchange transfusion serves a 2nd purpose of removing a quantity of the increased bilirubin resulting from the breakdown of RBCs as well as restoring the hgb level.
In crisis admin O2, and increase the fluid volume of the circulatory system to lower viscosity. (hypotonic .45 saline). No iron supplement causes iron buildup. take folic acid. While birthing keep well hydrated. In postpartal early ambulation and pressure stocking. |
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Describe the effects of cardiac decompensation?
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cardiac decompensation, a condition of congestive heart failure in which the heart is unable to ensure adequate cellular perfusion in all parts of the body without assistance. -Causes may include myocardial infarction, increased workload, infection, toxins, or defective heart valves.
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What are the S/S of Cardiac Decompensation?
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dyspena:(b/c fluid is backing up in the lungs)
-tachycardia -crackles -cough -generalized edema -chest pain (not always) |
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Fluid overload plus over worked heart =
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cardiac decompensation (Left ventricle)
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s/s of pt having Left sided heart failure?
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-orthopena
paroxysmal nocturnal -dyspnea (if the LV is failing the blood will back up into the lungs (pulm tree) |
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Right Sided Heart Failure :
Congenital heart defects such as pulmonary valve stenosis and atrial and ventricular septal defects can result in right sided heart failure. It occurs when the ouput of the right ventricle is less than the blood volume received by the right atrium from the vena cava. Back pressure from this results in congestion of the systemic venous circulation and decreased cardiac output to the lungs. S/S include: |
-Distended Liver and Spleen ( Portal Hypertension, Congestion and Edema)
-Ascites- fluid in the abdominal cavity -Peripheral Edema (if the Right side of the heart is not functioning well blood will back up into the liver) |
