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Develop a plan of care for the pregnant woman with pregestational or gestational diabetes.
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Compare the management of a pregnant woman with hyperthyroidism with one has
hypothyroidism. Hyperthyroidism - Tx propylthiouracil (PTU), B-Adrenergic blockers,
Radioactive iodine must not be used to diagnose because it compromises the fetal thyroid.
Thyroideectomy
Hypothyroidism - TX Levothyroxine (L-thyroxine [synthroid])
BOTH: need assistance with coping with the discomforts and frustrations associated with
symptoms of the disorder. both must adapt and wear appropriate clothing, avoiding enviromental
temperatures that cause them harm, and stress reduction activities.
EX. hyper- heat intolerance, nervousness, hyperactivity, weakness, fatigue.
Ex. hypo - cold intolerance.
,Both- need nutrional counseling the woman with hyper have an increased appetite and poor
weight gain and the hypo woman who are lethargy to ensure adequate intake of nutrition to meet
both maternal and fetal needs.
Differentiate the management of various cardiovascular disorders in pregnant woman. 1)
Peripartum Cardiomyopathy - TX diuretics, sodium restriction, afterload-reducing agents,
anticoagulants, digoxin. ACE- inhibitor only postpartum because it is teratogenic agent.
2) Rheumatic heart disease - The American heart association recommends prophylaxis to prevent
infective endocarditis only in those who are highest risk.
3) Mitral and Aortic Valve Stenosis - Reducing activity, sodium restriction, diuretic therapy, B-
blocking medication to lower HR, and increased bed rest.
4) Mitral Valve Prolapse (MVP) - specific tx is not necessary except for symptomatic
tachyarrythmias. Antibiotic prophylaxis may be given for invasive procedures.
5) Eisenmenger's Syndrome - physical activity is strictly limited and prophylactic
anticoagulation. intensive care monitoring .
6) Atrial and Ventricular Septal Defects - like eisenmenger syndrome
7) Tetralogy of Fallot - Surgical correction, anticoagulant therapy, high concetration oxygen
administration, hemodynamic monitoring during labor and birth as well as prophylactic
antibiotics.
8) Marfan syndrome -Limiting physical activity, preventing hypertensive or hypotensive
complications and administering B-blockers as needed.
,9) Heart Transplantation - B-blocking agent during labor to prevent tachycardia. After birth the
neonate may exhibit immunosuppresive effects in the first week life. Mother taking cyclosporine
should not breast feed.
therapy focus on minimizing stress on the heart, stress is greatest 28 to 32 wks gestation when
hemodynamic changes peak.The workload of the heart in decreased when Tx of any existing
emotional stress, hypertension, anemia, hyperthydism or obesity.
Discuss the different types of anemia and their effects during pregnancy. 1) Iron defiency
anemia - pathologic anemia of pregnancy is mainly the result of iron defiency. Iron is needed for
erythropoises.
2) Folic acid defiency anemia - increases incidence of neural tube defects, cleft lip and cleft
palate.
3) Sickle cell hemoglobinopathy - caused by the presence of abnormal hemoglobin in the blood.
Recurrent attacks of fever, pain in the abdomen or extremeties. Fetal complications- small for
gestational age, IUGR, and skeletal changes.
Pregnant woman are prone to pyelonephritis, leg ulcers, infections, bone abnormalities, strokes,
cardiopathy, congestive heart failure and preeclampsia.
, 4) Thalassemia - in which insufficient amount of globin is produced to fill the red blood cells.
50% stillbirth, IUGR, preeclampsia and preterm birth.
Explain the care of pregnant women with pulmonary diseases. ...
Describe the effects of gastrointestinal disorders on pregnancy. ...
Review the effects of neurologic disorders on pregnancy. ...
Describe the care of women whose pregnancies are complicated by autoimmune diseases.
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Explain the effects on and the management of pregnant women with human immunodefiency
virus. HIV counseling and testing should be offered to all women when they enter
prenatal care. All HIV-infected women should be treated with highly active anitretroviral therapy
(HAART) during pregnancy. Optimal health sleep, rest, exercise, and stress reduction. Use of
condoms and spermicide. No Orogenital sex.