Pregestaional conditions
Cards (32)
- Definition of high-risk pregnancy:
- A high-risk pregnancy is one in which a concurrent disorder, pregnancy-related complication, or external factor jeopardizes the health of the woman, the fetus, or both
- Psychological factors categorizing pregnancy as high risk:
- History of drug dependence (including alcohol)
- History of intimate partner abuse
- History of mental illness
- History of poor coping mechanisms
- Cognitively challenged
- Survivor of childhood sexual abuse
- Social factors categorizing pregnancy as high risk:
- Occupation involving handling of toxic substances
- Environmental contaminants at home
- Isolated
- Lower economic level
- Poor access to transportation for care
- High altitude
- Highly mobile lifestyle
- Poor housing
- Lack of support people
- Physical factors categorizing pregnancy as high risk:
- Visual or hearing challenges
- Pelvic inadequacy or misshape
- Uterine incompetency, position, or structure
- Secondary major illness (heart disease, diabetes mellitus, kidney disease, hypertension, chronic infection such as tuberculosis, hemopoietic or blood disorder, malignancy)
- Poor gynecologic or obstetric history
- History of previous poor pregnancy outcome (miscarriage, stillbirth, intrauterine fetal death)
- History of child with congenital anomalies
- Obesity (BMI >30)
- Underweight (BMI <18.5)
- Pelvic inflammatory disease
- (physical factors)
- History of inherited disorder
- Small stature
- Potential of blood incompatibility
- Younger than age 18 years or older than 35 years
- Cigarette smoker
- Substance abuser
- Cardiovascular disorders during pregnancy:
- Responsible for 5% of maternal deaths during pregnancy
- Common cardiovascular disorders causing difficulty during pregnancy: valve damage concerns from rheumatic fever or Kawasaki disease, congenital anomalies, coronary artery disease, and varicosities
- Blood volume and Cardiac Output increase approximately 30-50% during pregnancy
- Danger of pregnancy in a woman with Cardiac Disease occurs due to the increase in circulatory volume
- Risk of heart being overwhelmed by increased blood volume towards the end of pregnancy
- Preconception counseling is imperative for women with cardiac disease
- Allows for a complete history, physical, and workup to determine pregnancy risk and initiate treatment
- Assessment of a woman with cardiac disease:
- Thorough physical history
- Document changes in exercise performance, shortness of breath, coughing, edema, irregular pulse, chest pain, vital signs
- Diagnostic tests for cardiac disease:
- Echocardiogram
- Chest X-ray
- Electrocardiogram (ECG)
- Doppler Studies
- O2 Saturation Level
- Physical Activity
- Classification of pregnancy prognosis based on cardiac function:
- Class I: Uncompromised
- Class II: Slightly compromised
- Class III: Markedly compromised
- Class IV: Severely compromised
- Rheumatic Heart Disease:
- Heart valves permanently damaged by rheumatic fever
- Inflammatory connective tissue disease
- Symptoms include fever, weakness, fatigue, joint pain, increased risk for Congestive Heart Failure (CHF)
- Therapeutic management for Rheumatic Heart Disease:
- Surgery to replace or repair damaged valve
- Antibiotics and Anti-inflammatory drugs
- Peripartum Cardiomyopathy:
- Dysfunction of the left ventricle occurring in late pregnancy or postpartum
- Mortality rate as high as 50%
- Symptoms include dyspnea, chest pain, palpitations, fatigue, edema
- Therapeutic management for Peripartum Cardiomyopathy:
- Diuretics
- Beta-adrenergic blockers
- Digitalis Therapy
- Fluid and Sodium restriction
- Anti-coagulant therapy
- Strict Bed Rest
- Nursing interventions for pregnant women with cardiac disease:
- Promote rest
- Promote healthy nutrition
- Educate regarding medications
- Educate regarding infection prevention
- Be prepared for emergency actions
- Anemia and Pregnancy:
- Anemia results from having fewer red blood cells than normal
- Megaloblastic Anemia is often due to folic acid deficiency
- True anemia defined by low hemoglobin concentration during pregnancy
- Nursing diagnoses related to anemia during pregnancy:
- Ineffective tissue perfusion (cardiopulmonary)
- Social isolation
- Deficient knowledge regarding managing maternal cardiovascular disease
- Risk for ineffective tissue related to maternal anemia
- Definition of high-risk pregnancy:
- A high-risk pregnancy is one in which a concurrent disorder, pregnancy-related complication, or external factor jeopardizes the health of the woman, the fetus, or both
- Psychological factors categorizing pregnancy as high risk:
- History of drug dependence (including alcohol)
- History of intimate partner abuse
- History of mental illness
- History of poor coping mechanisms
- Cognitively challenged
- Survivor of childhood sexual abuse
- Social factors categorizing pregnancy as high risk:
- Occupation involving handling of toxic substances
- Environmental contaminants at home
- Isolated
- Lower economic level
- Poor access to transportation for care
- High altitude
- Highly mobile lifestyle
- Poor housing
- Lack of support people
- Physical factors categorizing pregnancy as high risk:
- Visual or hearing challenges
- Pelvic inadequacy or misshape
- Uterine incompetency, position, or structure
- Secondary major illness (heart disease, diabetes mellitus, kidney disease, hypertension, chronic infection such as tuberculosis, hemopoietic or blood disorder, malignancy)
- Poor gynecologic or obstetric history
- History of previous poor pregnancy outcome (miscarriage, stillbirth, intrauterine fetal death)
- History of child with congenital anomalies
- Obesity (BMI >30)
- Underweight (BMI <18.5)
- Pelvic inflammatory disease
- History of inherited disorder
- Small stature
- Potential of blood incompatibility
- Younger than age 18 years or older than 35 years
- Cigarette smoker
- Substance abuser
- Cardiovascular disorders during pregnancy:
- Responsible for 5% of maternal deaths during pregnancy
- Common concerns include valve damage from rheumatic fever or Kawasaki disease and congenital anomalies
- Increase in coronary artery disease and varicosities with delayed first pregnancy
- Blood volume and cardiac output increase 30-50% during pregnancy
- Preconception counseling is imperative for women with cardiac disease to determine pregnancy risk and optimize outcomes
- Assessment of a woman with cardiac disease:
- Thorough physical history
- Document changes
- Assess level of exercise performance
- Monitor symptoms like shortness of breath, coughing, edema, irregular pulse, chest pain, vital signs
- Diagnostic tests for cardiac disease:
- Echocardiogram
- Chest X-ray
- Electrocardiogram (ECG)
- Doppler studies
- O2 saturation level
- Physical activity assessment
- Classification of pregnancy prognosis based on cardiac function:
- Class I: Uncompromised
- Class II: Slightly compromised
- Class III: Markedly compromised
- Class IV: Severely compromised
- Rheumatic heart disease:
- Heart valve damage from rheumatic fever
- Symptoms include fever, weakness, fatigue, joint pain
- Increased risk for congestive heart failure, low birth weight, preterm labor
- Therapeutic management includes surgery, antibiotics, and anti-inflammatory drugs
- Peripartum cardiomyopathy:
- Heart failure in late pregnancy or postpartum
- Symptoms include dyspnea, chest pain, fatigue, edema
- Therapeutic management includes diuretics, beta-blockers, digitalis therapy, fluid and sodium restriction, anti-coagulants, strict bed rest
- Anemia and pregnancy:
- Anemia results from low red blood cell count
- Megaloblastic anemia is common due to folic acid deficiency
- Symptoms may not appear until the second trimester
- Diagnosis based on hemoglobin concentration levels
- Nursing diagnoses related to anemia during pregnancy
- Nursing interventions for pregnant women with cardiac disease:
- Promote rest
- Promote healthy nutrition
- Educate regarding medications
- Educate regarding infection prevention
- Be prepared for emergency actions