The main cause of diabetes-associated birth defects is ___ during the ___ trimester, when ___.
organ systems are forming
Maternal complications for women with diabetes include ___, ___, ___, and ___.
The incidence of ___ malformations is related to the ___ and ___ of the diabetes.
severity and duration
As pregnancy progresses, insulin requirements ___ for a woman with diabetes.
Pregnant women with diabetes are much more likely to develop ___ than ___.
Hyperthyroidism in pregnancy is ___, and hypothyroidism during pregnancy is ___ common than hyperthyroidism.
Heart disease complicates ___ to ___ of pregnancies.
0.5% to 2%
The major cardiovascular changes of pregnancy that affect women who have cardiac disease include ___, ___, ___, and ___.
increased intravascular volume
decreased systemic vascular resistance
cardiac output changes during labor and birth
intravascular volume changes just after birth
About ___ of women with mitral stenosis first become symptomatic during pregnancy.
Anemia affects as many as ___ of pregnant women.
___ may be the most common serious medical condition to complicate pregnancy.
The effect of pregnancy on ___ is unpredictable.
About ___ of patients with an autoimmune disease
are women of childbearing age.
The nurse is caring for a woman with mitral stenosis who is in the active stage of labor. Which action should the nurse take to promote cardiac function?
B. Maintain the woman in a side-lying position with the head and shoulders elevated to facilitate hemodynamics
A ___ delivery is the preferred method of delivery for a woman with cardiac disease because it sustains hemodynamics better than a ___.
The use of supportive care, medication, and narcotics or epidural regional analgesia is OR is notcontraindicated for a woman with heart disease.
The use of the Valsalva maneuver during pushing in the second stage should be avoided because it ___ and ___.
reduces diastolic ventricular filling
obstructs left ventricular outflow
In planning for the care of a 30-year-old woman with pregestational diabetes, the nurse recognizes that the most important factor affecting pregnancy outcome is the:
A. Degree of glycemic control during pregnancy.
A, B and C have no impact.
Diabetes in pregnancy puts the fetus at risk in several ways. Nurses should be aware that:
A. The most important cause of perinatal loss in diabetic pregnancy is congenital malformations.
T/F: Diabetes in pregnancy puts the fetus at risk in several ways. Nurses should be aware that with good control of maternal glucose levels, sudden and unexplained stillbirth is no longer a major concern.
Congenital malformations account for ___ of perinatal deaths.
30% to 50%
T/F: Diabetes in pregnancy puts the fetus at risk in several ways. Nurses should be aware that after birth the neonate of a diabetic mother is no longer in any risk.
False: The transition to extrauterine life often is marked by hypoglycemia and other metabolic abnormalities
T/F: With careful monitoring infants of mothers with diabetes have the same risks for respiratory distress syndrome as with non-diabetic mother.
False: Infants of diabetic mothers are at increased risk for respiratory distress syndrome.
A new mother with which of these thyroid disorders would be strongly discouraged from breastfeeding?
D. Phenylketonuria (PKU)
PKU is a cause of mental retardation in infants; mothers with PKU pass on phenylalanine through breast milk.
PKU is a cause of ___ in infants; mothers with PKU pass on phenylalanine through breast milk.
While providing care in an obstetric setting, the nurse should understand that postpartum care of the woman with cardiac disease:
B) B. Includes rest, stool softeners, and monitoring of the effect of activity.
Bed rest may be ordered, with or without bathroom privileges. Bowel movements without stress or strain for the woman are promoted with stool softeners, diet, and fluid.
T/F: While providing care in an obstetric setting, the nurse should understand that postpartum care of the woman with cardiac disease includes ambulating frequently, alternating with active range of motion.
False: The woman will be on bed rest to conserve energy and reduce the strain on the heart.
A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels. She shows the nurse her readings for the past few days. Which one should the nurse tell her indicates a need for adjustment (insulin or sugar)?
A. 60 mg/dl just after waking up from a nap; this is too low, maybe eat a snack before going to sleep
With gestational diabetes, any reading below ___ is too low. During hours of sleep glucose levels should not be under ___. Snacks before sleeping can be helpful.
The premeal acceptable range for blood glucose with women with gestational diabetes is ___ to ___ mg/dl.
65 to 95
With gestational diabetes the readings 1 hour after a meal should be less than ___ mg/dl.
With gestational diabetes the blood glucose readings two hours after eating should be under ___ mg/dl.
A woman with asthma is experiencing a postpartum hemorrhage. Which drug would NOT be used to treat her bleeding because it may exacerbate her asthma?
Prostaglandin derivatives should not be used to treat women with asthma, because they may exacerbate symptoms. Oxytocin is the recommended medication for uterine bleeding.
___ should not be used to treat pregnant women with asthma, because they may exacerbate symptoms. ___ is the recommended medication for uterine bleeding.
Oxytocin (generic or trade named Pitocin)
T/F: A woman with asthma is experiencing a postpartum hemorrhage. Fentanyl would NOT be used to treat her bleeding because it may exacerbate her asthma.
F: Fentanyl is used to treat pain, not bleeding. Trade Pitocin(generic oxytocin) would be the drug of choice to treat this woman’s bleeding because it would not exacerbate her asthma.
During a physical assessment of an at-risk patient, the nurse notes generalized edema, crackles at the base of the lungs, and some pulse irregularity. These are most likely signs of:
D. Cardiac decompensation.
These symptoms of cardiac decompensation may appear abruptly or gradually.
With regard to anemia, nurses should be aware that:
D. It is the most common medical disorder of pregnancy.
Anemia is the most common medical disorder of pregnancy. Combined with any other complication, anemia can result in congestive heart failure.
T/F: Reflex tachycardia is the heart response to the blood flow that increases immediately after birth.
False: reflex bradycardia
T:F: The most common form of anemia is caused by folate deficiency.
False: iron deficiency anemia
The most common neurologic disorder accompanying pregnancy is:
The effects of pregnancy on epilepsy are unpredictable.
Less than ___% of women who are substance abusers receive treatment for their addiction during pregnancy.
an excess of amniotic (~2L) fluid in the amniotic sac. It is seen in about 1% of pregnancies