Oral Revalida

• Preeclampsia


  A hypertensive disorder that manifests in pregnant women typically after 20 weeks of gestation, characterized by a consistent systolic blood pressure of 140 mmHg or higher and a diastolic blood pressure of 90 mmHg or higher at least two occasions at least four hours apart
• Eclampsia


  A more severe form of preeclampsia including seizures
• Affected Organ System


  • Reproductive System
• Reproductive System Organs


  • Ovaries
  • Uterine Tubes
  • Uterus
  • Vagina
  • Fetus
  • Placenta

  
• Predisposing Factors


  • Chronic Hypertension
  • Diabetes
  • Elderly pregnancy (≥35 years old)
  • Renal Disease
  • Heart Disease
  • Nulliparity
  • Multiple Gestation
• Precipitating Factors


  • Lack of Prenatal Care
  • Insufficient Nutrition
  • Emotional stress
• Symptoms


  • Elevated BP
  • Edema
  • Proteinuria
  • Oliguria
  • Elevated Pulse Rate
• Pathophysiology


  • Increased cardiac output demanded to sustain pregnancy
  • Injury to artery endothelial cells
  • Decreased vasodilator level of action
  • Excess thromboxane production
  • Vasospasm
• Laboratory Tests


  • CBC
  • Creatinine
  • SGPT
  • Platelets
  • Urine Testing
• Medical Management


  • Antihypertensives
  • Magnesium sulfate (MgSO4)
  • Oxytocin
• Surgical Management


  • Cesarean delivery
• Nursing Diagnoses


  • Decreased cardiac output
  • Risk for imbalanced fluid volume
  • Ineffective tissue perfusion
  • Risk for injury
  • Risk of magnesium toxicity
• General Nursing Interventions


  • Assess patient and family understanding
  • Promote reduced activity and rest
  • Monitor BP and PR
  • Encourage family monitoring
  • Instruct on dietary plan
  • Educate on treatment adherence
• If treated, good prognosis. If not treated, can cause eclampsia, HELLP syndrome, multiple organ failure, and death
• Tetralogy of Fallot


  A cyanotic defect defined by 4 components: pulmonary artery stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy
• Heart Anatomy


  • Walls (endocardium, myocardium, epicardium)
  • Chambers (right atrium, right ventricle, left atrium, left ventricle)
  • Valves (tricuspid, mitral, aortic, pulmonary)
  • Blood vessels (arteries, veins, capillaries)
  • Electrical conduction system (SA node, AV node, bundle branches, Purkinje fibers)

  
• The cause of Tetralogy of Fallot is unknown, but thought to be due to environmental or genetic factors
• Predisposing Factors


  • DiGeorge Syndrome/chromosome 22 deletion
• Precipitating Factors


  • Stress
  • Rubella
  • Alcoholism and smoking of the mother
• Symptoms


  • Cyanosis
  • Tet Spells
  • Dyspnea on exertion
  • Clubbing of fingers and toes
  • Heart murmurs
  • Low birth weight
  • Poor feeding
  • Delayed growth and development
• Pathophysiology


  • Alteration of fetal development; unequal growth of the aorticopulmonary septum
  • Anterior and cephalad deviation of the infundibular septum
  • Malalignment of Ventricular Septal Defect
  • Conal septum going right
• Diagnostic Tests


  • Chest X-ray
  • ECG
  • Echocardiography
  • Cardiac catheterization
• Medical Management


  • Knee-chest position and oxygen/morphine
  • Beta blockers (propranolol)
  • Palliative surgery (Blalock-Taussig procedure)
  • Complete surgical closure (Brock procedure)
• Medications


  • Morphine
  • Phenylephrine
  • Metoprolol
• Surgical Management


  • Blalock-Taussig procedure
  • Brock procedure

  
• Nursing Diagnoses


  • Impaired Gas Exchange
  • Ineffective Breathing Pattern
  • Decreased Cardiac Output
  • Impaired Tissue Perfusion
  • Risk for Injury
• Metoprolol


  Administration of beta-blockers helps in reducing heart rate, improves cardiac filling, and may increase systemic vascular resistance
• Surgical Management


  1. Palliative surgery to reduce hypoxia during tet spells (involving the Blalock-Taussig procedure, which joins the subclavian artery to the pulmonary artery)

  2. Brock procedure; complete surgical closure to relieve pulmonic stenosis and close the VSD, directions left ventricular outflow to the aorta
• RELIEF OF PULMONARY STENOSIS IN THE TETRALOGY OF FALLOT

  Surgical procedures to improve blood flow to the lungs and relieve pulmonic stenosis
• Veins


  Carry blood from your organs and towards your heart
• Arteries


  Carry blood away from your heart
• Guillain-Barré syndrome


  An autoimmune attack of the peripheral nerve myelin
• Guillain-Barré syndrome


  • A medical emergency wherein the body's immune system attacks part of the peripheral nervous system
  • An autoimmune disease that affects the nerves that control muscle movement as well as those that transmit pain, temperature, and touch sensations
  • A rare disorder that can result in muscle weakness, loss of sensation in the legs and/or arms, and problems swallowing or breathing
• Nervous system


  The body's control center and communication network. It directs the functions of the body's organs and systems. It allows us to interpret what is occurring in our external environment and helps us to decide how to react to any environmental change or stimulus by causing muscular contractions
• Parts of Neuron


  • Neuron
  • Dendrites
  • Axon
  • Cell body or soma

  
• Dementia


  A set of symptoms, an umbrella term, for a set of symptoms caused by physical disorders affecting the brain. It is the decrease in cognitive ability and memory with fully intact consciousness
• Alzheimer's disease


  The most common cause of dementia accounting (60% to 80%)
• Recovery from Guillain-Barré syndrome


  • Can vary from months to a year or more, depending on the severity
  • Some still experience muscle weakness even after three years after being diagnosed
• If not treated, Guillain-Barré syndrome can lead to respiratory failure and autonomic dysfunction
• Dementia


  A set of symptoms, an umbrella term, for a set of symptoms caused by physical disorders affecting the brain. It is the decrease in cognitive ability and memory with fully intact consciousness.