N 3280 High Risk Pregnancy Part 1 Exam
With Correct Answers
advanced maternal age - ANSWER age 35 or older at the time of delivery (not
conception)
what type of pregnancy is common in AMA - ANSWER multiple pregnancies are more
common (fraternal)
increased risks for mother of AMA - ANSWER -gestational diabetes
-pregnancy induced hypertension
-preterm labor/delivery
-chromosomal abnormalities
-pregnancy lost
pregestational diabetes - ANSWER -pancreas does not produce enough insulin to allow
carbohydrate metabolism
-glucose cant enter the cells and continues to circulate in the blood
energy source for pregestational diabetes - ANSWER fats and proteins
ketosis - ANSWER wasting of proteins
result of pregestational diabetes - ANSWER -cellular dehydration due to osmotic force
of glucose concentration in the blood
-high levels of blood glucose eventually spill into urine
cardinal signs of diabetes - ANSWER -polyuria
-polydipsia
-polyphagia
-weight loss
type 1 pregestational diabetes - ANSWER -autoimmune
-develops because of B cell destruction, complicated by vascualr disease, retinopathy,
or neuropathy
-insulin dependent
,type 2 pregestational diabetes - ANSWER -most common
-combination of insulin secretory defect and insulin deficiency
gestational diabetes mellitus (GDM) - ANSWER glucose intolerance with onset during
pregnancy (usually around 24 weeks)
when should you work to stabilize blood sugar levels - ANSWER before pregnancy
infant risks for hyperglycemia during pregnancy - ANSWER -early embryonic/fetal
development can case cardiovascular, renal, and neurodevelopmental congenital
malformations
-can lead to fetal death
-macrosomia
-newborn hypoglycemia later in pregnancy
DM management during pregnancy - ANSWER -complete history
-physical exam
-diagnosis if necessary
-lab tests
-patient should be monitored frequently
-eye exam due to increased damage potential
lab tests for DM - ANSWER -baseline renal function
-UA and culture
-glycosylated hemoglobin A
dietary changes for DM pregnancy - ANSWER -careful carbohydrate counting is
preferred dietary approach to glycemic control
-registered dietitian or certified diabetic educator should be added to the team
-advised diet
advised diet for DM - ANSWER -complex, high fiber carbohydrates
-protein
-unsaturated fats
-limit artificial sweeteners
treatment for DM - ANSWER -insulins (preferred treatment for non-diet/exercise
, controlled diabetes)
-oral hypoglycemic agents (cross placenta)
-self-monitoring, glucose logs
fasting and premeal glucose goal - ANSWER <95 mg/dL
one-hour postprandial glucose goal - ANSWER <140 mg/dL
two-hours postprandial glucose goal - ANSWER <120 mg/dL
during the nigh glucose goal - ANSWER levels should be maintained >60mg/dL
HgbA1C glucose goal - ANSWER <6% has the lowest risk for LGA
gestational diabetes - ANSWER -not caused by lack of insulin
-pregnancy hormonal shifts can lead to insulin resistance
-typically develops around 24th week
risk factors for gestational diabetes - ANSWER -overweight
-AMA
-family history of diabetes
-race
-prediabetes
which races are at highest risk for gestational diabetes - ANSWER AA
AAPI
Hispanic
native american
high risk women for gestational diabetes - ANSWER -age
-race
-weight
-previous GDM pregnancy
-previous macrocosmic baby
-HTN
-elevated A1C
With Correct Answers
advanced maternal age - ANSWER age 35 or older at the time of delivery (not
conception)
what type of pregnancy is common in AMA - ANSWER multiple pregnancies are more
common (fraternal)
increased risks for mother of AMA - ANSWER -gestational diabetes
-pregnancy induced hypertension
-preterm labor/delivery
-chromosomal abnormalities
-pregnancy lost
pregestational diabetes - ANSWER -pancreas does not produce enough insulin to allow
carbohydrate metabolism
-glucose cant enter the cells and continues to circulate in the blood
energy source for pregestational diabetes - ANSWER fats and proteins
ketosis - ANSWER wasting of proteins
result of pregestational diabetes - ANSWER -cellular dehydration due to osmotic force
of glucose concentration in the blood
-high levels of blood glucose eventually spill into urine
cardinal signs of diabetes - ANSWER -polyuria
-polydipsia
-polyphagia
-weight loss
type 1 pregestational diabetes - ANSWER -autoimmune
-develops because of B cell destruction, complicated by vascualr disease, retinopathy,
or neuropathy
-insulin dependent
,type 2 pregestational diabetes - ANSWER -most common
-combination of insulin secretory defect and insulin deficiency
gestational diabetes mellitus (GDM) - ANSWER glucose intolerance with onset during
pregnancy (usually around 24 weeks)
when should you work to stabilize blood sugar levels - ANSWER before pregnancy
infant risks for hyperglycemia during pregnancy - ANSWER -early embryonic/fetal
development can case cardiovascular, renal, and neurodevelopmental congenital
malformations
-can lead to fetal death
-macrosomia
-newborn hypoglycemia later in pregnancy
DM management during pregnancy - ANSWER -complete history
-physical exam
-diagnosis if necessary
-lab tests
-patient should be monitored frequently
-eye exam due to increased damage potential
lab tests for DM - ANSWER -baseline renal function
-UA and culture
-glycosylated hemoglobin A
dietary changes for DM pregnancy - ANSWER -careful carbohydrate counting is
preferred dietary approach to glycemic control
-registered dietitian or certified diabetic educator should be added to the team
-advised diet
advised diet for DM - ANSWER -complex, high fiber carbohydrates
-protein
-unsaturated fats
-limit artificial sweeteners
treatment for DM - ANSWER -insulins (preferred treatment for non-diet/exercise
, controlled diabetes)
-oral hypoglycemic agents (cross placenta)
-self-monitoring, glucose logs
fasting and premeal glucose goal - ANSWER <95 mg/dL
one-hour postprandial glucose goal - ANSWER <140 mg/dL
two-hours postprandial glucose goal - ANSWER <120 mg/dL
during the nigh glucose goal - ANSWER levels should be maintained >60mg/dL
HgbA1C glucose goal - ANSWER <6% has the lowest risk for LGA
gestational diabetes - ANSWER -not caused by lack of insulin
-pregnancy hormonal shifts can lead to insulin resistance
-typically develops around 24th week
risk factors for gestational diabetes - ANSWER -overweight
-AMA
-family history of diabetes
-race
-prediabetes
which races are at highest risk for gestational diabetes - ANSWER AA
AAPI
Hispanic
native american
high risk women for gestational diabetes - ANSWER -age
-race
-weight
-previous GDM pregnancy
-previous macrocosmic baby
-HTN
-elevated A1C