Ob Chapter 14 (Cont'd)

Front 1

What is Mitral Stenosis?

Back 1

Failure of the mitral valve to open completely.

Front 2

What is Mitral Valve prolapse?

Back 2

Mitral valve leaflets tend to prolapse into the left atruim during ventricle systole because the chordae tendinae that support them are long,stretched and thin.

Front 3

What signs and symptoms indicate cardiac compromise?

Back 3

Indicative signs of CHF are frequent cough, dyspnea, edema, heart murmurs, palpitations, rales and weight gain.

Front 4

What special nursing care is indicated for the cardiac mother?

Back 4

During the first half of pregnancy, the woman is seen approximately every 2 weeks to assess cardiac status. During the second half of pregnancy the woman is seen weekly. These assessments are especially important between weeks 28 and 30 when the blood volume reaches its maximum.

Front 5

What special nursing care is indicated for the cardiac mom during labor?

Back 5

Vital signs are monitored - a pulse rate greater than 100 beats/minute or respiratins greater than 24/minute may indicate the onset of cardiac decompensation and warrant further evaluation. Continuous fetal monitoring is also done.

Front 6

What is peripartum cardiomyopathy?

Back 6

It is a dysfunction of the left ventricle - cause is unknown but the mortality rate is high. Symptoms are like CHF (dyspnea, othopnea, fatigue, cough, chest pain, palpitations, edema). Subsequent pregnancy is strongly discouraged because the disease tends to recur during pregnancy.

Front 7

What are the effects of cardiomyopathy on the pregnancy?

Back 7

Signs of CHF as well as the woman may have an enlarged heart, tachycardia, rales, and a third heart sound.

Front 8

What are the classifications of heart disease?

Back 8

Class I - asymptomatic, no limitations of physical activity.
Class II - slight limitation of physical activity. Asymptomatic at rest; symptoms occur with ordinary physical activity.
Class III - marked limitation of physical activity. Comfortable at rest but symptomatic during less-than-ordinary physical activity.
Class IV - inability to carry on any physical activity without discomfort. Even at rest the person experiences symptoms of cardiac innsufficiency or anginal pain; discomfort increases with any physical activity.

Front 9

What are the nursing considerations of caring for a cardiac client in labor?

Back 9

The intrapartal care for a woman with cardiac disease is aimed at reducing physical exertion and the accompanying fatigue. Monitor VS and signs and symptoms of CHF, oxygen by mask if needed, diuretics to reduce fluid retention, sedatives and analgesics, prophylactic antibiotics, digitalis, remain with the woman and keep her family informed, continuous fetal monitoring.

Front 10

What postpartum care is indicated for the cardiac client and why?

Back 10

Postpartum period is a significant time as extravascular fluid returns to the bloodstream, as result the strain may lead to decompensation especially in the first 48 hours.
VS are monitored, she is assessed for decompesation, she is to stay in a side-lying of semi-fowler's position and begins a gradual progressive activity program. Appropriate diet and stool softeners facilitate bowel movement without undue strain. The only concern about breastfeeding is related to medications the mother may be taking.