Week 2 Topic 1

• Hyperemesis gravidarum (HEG) is persistent, uncontrollable vomiting that begins in the first weeks of pregnancy and may continue throughout pregnancy
• HEG is associated with loss of 5% or more of prepregnancy weight, dehydration, acidosis from starvation, elevated levels of blood and urine ketones, alkalosis from loss of hydrochloric acid in the gastric fluids, and hypokalemia
• The cause of HEG is not known (idiopathic), but it is more common among unmarried White women, during first pregnancies, and in multifetal pregnancies
• Therapeutic management includes exclusion of other causes of persistent nausea and vomiting, laboratory studies, and drug therapy if vomiting becomes severe
• Nursing considerations involve evaluating laboratory data to determine fluid and metabolic status, monitoring signs of dehydration, and providing interventions to reduce nausea and vomiting
• Pregnancy-induced hypertension (PIH) is a condition in which vasospasm occurs during pregnancy in both small and large arteries, leading to signs of hypertension, proteinuria, and edema
• PIH tends to occur most frequently in women of color, those with multiple pregnancies, primiparas younger than 20 years or older than 40 years, and those with underlying diseases such as heart disease or diabetes
• Vascular spasm in PIH may be caused by increased cardiac output, leading to endothelial cell injury and vasoconstriction, resulting in increased blood pressure
• Gestational hypertension is when a woman develops elevated blood pressure without proteinuria or edema, while mild pre-eclampsia involves proteinuria and blood pressure rising to 140/90 mm Hg
• Severe pre-eclampsia is characterized by blood pressure rising to 160/110 mm Hg, marked proteinuria, extensive edema, and potential seizures or coma, while eclampsia is the most severe stage with seizures or coma
• Gravido-Cardiac/Heart Disease in Pregnancy involves hemodynamic changes, symptoms of true heart disease, and diagnostics such as ECG, echocardiography, and chest x-ray (avoided during pregnancy)
• Symptoms of true heart disease include orthopnea, nocturnal cough, syncope, hemoptysis, cyanosis, clubbing of fingers, persistent neck vein distension, additional heartbeat, cardiomegaly, arrhythmia, and pulmonary hypertension
• Diagnostics for heart disease in pregnancy include ECG, echocardiography, and chest x-ray (avoided during pregnancy)
• If a pregnant woman has cardiac problems, there might be a decrease in oxygen, affecting the prognosis of continuing with the pregnancy and survival
• Heparin is the drug of choice for anticoagulant in pregnant women
• Digitalize - Digoxins or antiarrhythmic medications
• First stage of labor is Dilatation
• Second stage of labor is Baby delivery
• Third stage of labor is Placental delivery
• Furosemide is also known as Lasix
• Morphine is used for pain management
• Intrauterine Contraceptive Device (IUCD) is a form of contraceptive
• Depot medroxyprogesterone acetate (DMPA) is an injectable, progestin-only contraceptive that provides highly effective, private, three-month-long, reversible contraception
• COC - oral contraceptives
• Mother is more at risk in developing venous thrombosis
• Pancreas secretes insulin which is key to glucose entering cells for energy
• 3 P’s of DM:

  • Polyuria - urinate more than normal
  • Polydipsia - excessive thirst
  • Polyphagia (hyperphagia) - feeling of extreme, insatiable hunger
• Hyperglycemia - retained blood sugar or the serum glucose level increase. Normal 80-120 mg/dL. Above is hyperglycemia
• Glycosuria - Glucose in the urine
• Dehydration due to polyuria - Increase glucose in the urine decrease fluid reabsorption in the kidney and large quantity of the fluids are lost in the urine (polyuria)
• Reduced blood flow - increase in sugar in blood (hyperglycemia), reduce blood flow because it will be viscous
• Ketones into the bloodstream - cells are starved, our body will try to compensate by breaking down fats. Can be seen in urine. Diabetic ketone acidosis or ketones breathe
• Metabolic acidosis - output of fats and protein breakdown which is acidic
• Long term effects of Diabetes Mellitus include renal failure, diabetic retinopathy, hypertension, cardiac diseases, and diabetic foot
• Gestational Diabetes Mellitus (GDM) can lead to hyperglycemia in the fetus
• Rh incompatibility occurs when an Rh-negative mother carries a fetus with an Rh-positive blood type
• Hemolytic disease of the fetus and newborn (HDFN) is caused by the destruction of neonatal red blood cells by maternal immunoglobulin G antibodies
• Rh (D) immune globulin (RhIG) is administered to women who are Rh-negative at 28 weeks of pregnancy to prevent the formation of Rh antibodies
• Erythropoiesis is the creation of red blood cells
• Megaloblastic anemia is a type of anemia wherein RBCs are not formed properly