NUR 145: MCN 2 LEC

• Respond to students' feedback during the next class meeting or as soon as possible.
• Anemia is a condition of too few red blood cells or a lowered ability of the red blood cells.
• Many women lack the sufficient amount of iron needed for the second and third trimesters.
• When the body needs more iron than it has available, a woman can become anemic.
• Mild anemia is normal during pregnancy due to an increase in blood volume.
• More severe anemia can put the baby at higher risk for anemia later in infancy.
• The most common types of anemia during pregnancy are Iron deficiency Anemia, Vitamin B12 Anemia, Anemia due to Blood Loss, Folate Deficiency, and G6PD Deficiency.
• Risk factors for anemia during pregnancy include poor nutrition, excess alcohol consumption, illnesses that reduce absorption of nutrients, use of anticonvulsant drugs, previous use of oral contraceptives, and G6PD Deficiency.
• Complications of anemia during pregnancy can include premature labor, intrauterine growth retardation, dangerous anemia from normal blood loss during labor, increased susceptibility to maternal infection after childbirth, and more.
• Iron Deficiency Anemia is the most common type, develops in the 2nd & 3rd trimester when the Fe requirements increase to compensate for the expanding blood volume.
• Predisposing factors for Iron Deficiency Anemia include poor diet & poor nutrition, heavy menses, successive pregnancies within 2 years or less than 6 months interval, unwise reducing programs, low socioeconomic status.
• Poor gastric absorption due to gastric bypass for morbid obesity can cause Iron Deficiency Anemia.
• Erina will be having a case presentation regarding the complications of Anemia in pregnancy.
• Premature labor, Intrauterine growth retardation (IUGR), Dangerous anemia from normal blood loss during labor, requiring transfusions, and Poor diet & poor nutrition are all complications of Anemia in pregnancy.
• A woman at 36 years of age can also develop Iron Deficiency Anemia.
• Hyperemesis Gravidarum is characterized by extreme nausea and vomiting that is prolonged past week 12 of pregnancy or is so severe.
• Management for Hyperemesis Gravidarum includes 24-hour Hospitalization, if no vomiting after the first 24 hours, sips of clear fluid gradually advanced to a soft, then normal, diet, and if vomiting returns, TPN or enteral nutrition may be prescribed.
• Karlie is experiencing sharp shoulder pain, which is a symptom of Ectopic Pregnancy.
• Multiple pregnancies can lead to increased fetal demand and cause Iron Deficiency Anemia.
• A woman with secondary hemolytic illness can also develop Iron Deficiency Anemia.
• Ectopic Pregnancy is commonly located in the fallopian tube.
• An ecchymotic blueness around the umbilicus is a sign of Kehr ’ s Sign.
• Iron Deficiency Anemia can occur in 4 patients coming to the Out Patient Department.
• Signs & symptoms of Iron Deficiency Anemia include easy fatigability, sensitivity to cold, dizziness, brittle, flattened nails, changes in vital signs, and more.
• Folic Acid is the common form of vitamin B9 present in many whole foods, including leafy greens, beans, eggs, citrus fruit, avocados, and beef liver, while Folate is a synthesized version of vitamin B9 that is added to processed foods and the common version used in supplements.
• Utz confirms extrauterine pregnancy & rupture.
• Kehr’s Sign, referred shoulder pain due to blood in the peritoneum irritating the phrenic nerve, is a complication of ectopic pregnancy.
• Assess for bleeding & pain, monitor VS, start IV with 18-gauge needle, provide O2 therapy, administer RhOGAM if Rh (-), and provide emotional support are management measures for ectopic pregnancy.
• Dizziness and syncope are symptoms of ectopic pregnancy.
• Before rupture, oral administration of METHOTREXATE (folic acid antagonist which destroys fast-growing cells) followed by LEUCOVORIN is recommended until hCG is (-).
• Missed period, usual signs of pregnancy (Nausea and Vomiting, positive pregnancy test, etc) are indicators of pregnancy.
• Factors that put the patient at risk of developing anemia in pregnancy include poor nutrition, excess alcohol consumption, illnesses that reduce absorption of nutrients, use of anticonvulsant drugs, and elevated hematocrit due to hemoconcentration.
• Cullen’s Sign, ecchymotic blueness around the umbilicus indicating blood pooling in the peritoneum, is a complication of ectopic pregnancy.
• If the fallopian tube ruptures between 6 to 12 weeks AOG, it can cause a slowly increasing or sudden sharp, stabbing pain in the LLQ or RLQ, followed by bleeding and abdominal rigidity.
• After rupture, BT if needed, laparoscopy to ligate bleeding vessels & remove or repair damaged tubes is recommended.
• Spotting, bleeding (dark red or brownish), is a possible sign of hypovolemic shock.
• Hemorrhage, shock, and peritonitis are complications of ectopic pregnancy.
• Iron Deficiency Anemia is a type of Anemia that can be seen in pregnancy, along with Vitamin B12 Anemia, Anemia due to Blood Loss, Folate Deficiency, and Thalassemia.
• Diagnosis of Iron Deficiency Anemia includes lab findings such as low hemoglobin, low hematocrit, low serum ferritin, low serum iron, hypochromic, microcytic RBCs, and more.
• Management of Iron Deficiency Anemia includes prophylactic iron supplementation in pregnancy, daily supplementation with 300 mg ferrous sulfate which contains 60 mg elemental iron, and more.