MCN EXAM 4 2026 POSTPARTUM
COMPLICATIONS HEMORRHAGE
INFECTION AND THROMBOEMBOLISM
NURSING CARE GUIDE
◉ maple Syrup Urine Disease (MSUD)
Answer: Affects metabolism of certain amino acids. Build up of acids
causes ketoacidosis.
◉ Galactosemia
Answer: infants cannot properly digest milk or sugar
◉ Tay-Sachs Disease
Answer: Rare inherited disorder (Jewish) that progressively
destroys nerve cells (neurons) in the brain and spinal cord. Death
occurs during early childhood
◉ Phenylalanine Hydroxylase Deficiency (Phenylketonuria PKU)
Answer: • This deficiency results in toxic accumulation of
phenylalanine in the bloodstream after ingesting protein containing
phenylalanine
• Results in Central Nervous System damage (>600 micro-mol/L)
,• Cause: Genetic Metabolic Disorder
• Symptoms: digestive problems, vomiting, musty or mousy odor to
urine, infantile
eczema, hypertonia, hyperactive behavior
• Tests: Newborn Screen, PAH mandatory in all 50 states
Need to avoid all protein
◉ Congenital Adrenal HyPerplasia (CAH) ****
Answer: Group of inherited disorders of the adrenal glands where
thereis a lack of enzymes to make the hormones cortisol
(glucocorticoid) & aldosterone (mineralocorticoid)
•Physical findings
• Girls: ambiguous genitalia, failure to menstruate, growth problems
• Boys: early development of male characteristics, growth problems
•Tests: serum renin levels, serum cortisol levels, X-rays (boneage),
Newborn Screen. Elevated levels of 17-hydroxyprogesterone
confirm the dx
•Treatment: Hormone replacement
,•Glucocorticoid (Hydrocortisone acetate, cortisone acetate)
•Mineralocorticoid (Fludrocortisone acetate- Florinef)
◉ CAH continued ****
Answer: • Low **mineralocorticoid production results in renal salt
wasting
• Most common form of CAH, manifests in early weeks of life
• Salt wasting crisis **life threatening**•
Hypovolemia ->> hypotensive crisis/ shock
• Hyponatremia >> risk for seizures
• Hyperkalemia >> risk for cardiac dysrhythmias
• Treat with prompt fluid/electrolyte management and oral
glucocorticoid & mineralocorticoid replacement
• FLORINEF for replacement therapy
• If vomiting, need hydrocortisone
• ******Require "stress dose" steroids (usually doubled home
dose)when febrile, ill/injured, or having surgery*******
, ◉ Congenital Hypothyroidism
Answer: •Thyroid gland does not produce sufficient thyroid
hormones to meet the body's metabolic needs
Under production of T4 ****
•Causes: Fetal thyroid fails to develop properly
•Symptoms: Large fontanel, large tongue, hypotonia, slow reflexes,
prolonged jaundice, feeding problems, skin mottling
•Tests: Newborn screen
Treatment: Lifelong throids hormone replacement
◉ Acquired Hypothyroidism
Answer: Something caused it
•Thyroid gland produces inadequate amount of thyroid hormone to
meet metabolic needs
•Causes: Autoimmune process,thyroidectomy, radiation
COMPLICATIONS HEMORRHAGE
INFECTION AND THROMBOEMBOLISM
NURSING CARE GUIDE
◉ maple Syrup Urine Disease (MSUD)
Answer: Affects metabolism of certain amino acids. Build up of acids
causes ketoacidosis.
◉ Galactosemia
Answer: infants cannot properly digest milk or sugar
◉ Tay-Sachs Disease
Answer: Rare inherited disorder (Jewish) that progressively
destroys nerve cells (neurons) in the brain and spinal cord. Death
occurs during early childhood
◉ Phenylalanine Hydroxylase Deficiency (Phenylketonuria PKU)
Answer: • This deficiency results in toxic accumulation of
phenylalanine in the bloodstream after ingesting protein containing
phenylalanine
• Results in Central Nervous System damage (>600 micro-mol/L)
,• Cause: Genetic Metabolic Disorder
• Symptoms: digestive problems, vomiting, musty or mousy odor to
urine, infantile
eczema, hypertonia, hyperactive behavior
• Tests: Newborn Screen, PAH mandatory in all 50 states
Need to avoid all protein
◉ Congenital Adrenal HyPerplasia (CAH) ****
Answer: Group of inherited disorders of the adrenal glands where
thereis a lack of enzymes to make the hormones cortisol
(glucocorticoid) & aldosterone (mineralocorticoid)
•Physical findings
• Girls: ambiguous genitalia, failure to menstruate, growth problems
• Boys: early development of male characteristics, growth problems
•Tests: serum renin levels, serum cortisol levels, X-rays (boneage),
Newborn Screen. Elevated levels of 17-hydroxyprogesterone
confirm the dx
•Treatment: Hormone replacement
,•Glucocorticoid (Hydrocortisone acetate, cortisone acetate)
•Mineralocorticoid (Fludrocortisone acetate- Florinef)
◉ CAH continued ****
Answer: • Low **mineralocorticoid production results in renal salt
wasting
• Most common form of CAH, manifests in early weeks of life
• Salt wasting crisis **life threatening**•
Hypovolemia ->> hypotensive crisis/ shock
• Hyponatremia >> risk for seizures
• Hyperkalemia >> risk for cardiac dysrhythmias
• Treat with prompt fluid/electrolyte management and oral
glucocorticoid & mineralocorticoid replacement
• FLORINEF for replacement therapy
• If vomiting, need hydrocortisone
• ******Require "stress dose" steroids (usually doubled home
dose)when febrile, ill/injured, or having surgery*******
, ◉ Congenital Hypothyroidism
Answer: •Thyroid gland does not produce sufficient thyroid
hormones to meet the body's metabolic needs
Under production of T4 ****
•Causes: Fetal thyroid fails to develop properly
•Symptoms: Large fontanel, large tongue, hypotonia, slow reflexes,
prolonged jaundice, feeding problems, skin mottling
•Tests: Newborn screen
Treatment: Lifelong throids hormone replacement
◉ Acquired Hypothyroidism
Answer: Something caused it
•Thyroid gland produces inadequate amount of thyroid hormone to
meet metabolic needs
•Causes: Autoimmune process,thyroidectomy, radiation
