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Pregnancy and Pre-existing Medical Conditions Study Guide

This guide provides a comprehensive overview of hypertensive diseases in pregnancy (HTDP), a common complication affecting 8-10% of pregnancies. It details the different types of hypertensive disorders, including chronic hypertension, gestational hypertension, preeclampsia (with and without severe features), superimposed preeclampsia, eclampsia, and HELLP syndrome. The content explores the underlying pathophysiology, identifying key risk factors such as nulliparity, advanced maternal age, obesit

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Adolescent and Advanced Maternal Age Pregnancy

Adolescent and Advanced Maternal Age Pregnancy

This material covers developmental stages of adolescence, risks and challenges of adolescent pregnancy, and nursing care for advanced maternal age pregnancies.

  • Stages of Adolescence
  • Early Adolescent
  • Middle Adolescent
  • Late Adolescent
  • Factors Contributing to Adolescent Pregnancy
  • Risks associated with adolescent pregnancy
  • PIH
  • Pre-term, LBW, and stillbirth
  • SIDS
  • Nursing Care of the Pregnant Adolescent
  • Advanced Maternal Age
  • Screening and Testing
  • Triple Screen
  • Quadruple Screen
  • Amniocentesis

Pregestational Diseases and Anemia Management

Pregestational Diseases and Anemia Management

This handout defines high risk pregnancy and discusses iron and folic acid deficiency anemia including risk factors, symptoms, and treatment.

  • High Risk Pregnancy
  • Iron Deficiency Anemia
  • Folic Acid Deficiency Anemia
  • Maternal Risks
  • Fetal Risks
  • Ferrous Sulfate
  • Neural Tube defects
  • Spina Bifida

Hypertensive Diseases in Pregnancy Overview

Hypertensive Diseases in Pregnancy

Hypertensive diseases in pregnancy include gestational hypertension, preeclampsia, chronic hypertension, eclampsia, and HELLP syndrome.

  • Gestational Hypertension
  • Preeclampsia
  • Chronic Hypertension
  • Eclampsia
  • HELLP Syndrome
  • Maternal morbidity and mortality
  • Predisposing factors
  • Severe features
  • Proteinuria
  • Placental abruption
  • Preterm delivery
  • Intrauterine growth restriction (IUGR)

Management of Heart Disease and Pregnancy

Heart Disease and Pregnancy Management

Management of heart disease in pregnancy including NYHA functional classification, antepartal care, intrapartum goals, and post-partum considerations.

  • Maternal mortality
  • Cardiac reserve
  • Spontaneous abortion
  • Pre-term labor
  • IUGR
  • Antepartal care
  • Cardiac workload
  • Intrapartum care
  • Cardiac decompensation
  • Post-partum care
  • Congestive heart failure

Gestational Risks and Preterm Labor Management

Gestational Risks and Hyperemesis Gravidarum

  • Nausea and Vomiting in Pregnancy (NVP)
  • Hyperemesis Gravidarum
  • Etiology of NVP
  • Hyperemesis Gravidarum risk factors
  • Clinical manifestations of Hyperemesis Gravidarum
  • Assessment of Hyperemesis Gravidarum
  • Hyperemesis Gravidarum interventions

Gestational Risks and Preterm Labor

This content discusses cervical insufficiency, premature rupture of membranes, and preterm labor including etiology, risk factors, diagnosis, and management.

  • Cervical insufficiency
  • Premature rupture of membranes
  • Preterm labor
  • Cervical cerclage
  • Tocolytics
  • Chorioamnionitis
  • Endometritis
  • Magnesium sulfate
  • Glucocorticoids

Vaginal and Bimanual Examination Techniques

Antepartal Nursing Assessment and Management

Focused physical assessment, laboratory testing, and screening tools used during the first, second, and third trimesters of pregnancy.

  • Fundal height measurement
  • Fetal heart tones
  • Rh factor and Rhogam administration
  • Syphilis serology
  • Rubella immunity and vaccination
  • Quad screen and chromosomal anomalies
  • Oral glucose tolerance testing
  • Gestational diabetes screening
  • Group B Strep screening
  • Urinalysis for protein and glucose
  • Fetal movement counts

Management of Hypertension, Thyroid, and Asthma

Pregestational Diseases in Pregnancy

Management and risks of chronic hypertension, hyperthyroidism, hypothyroidism, and asthma during pregnancy.

  • Chronic Hypertension in Pregnancy
  • Preeclampsia
  • Hyperthyroidism
  • Graves Disease
  • Propylthiouracil
  • Thyroidectomy
  • Hypothyroidism
  • Levothyroxine
  • Hashimoto’s disease
  • Asthma in Pregnancy

Pathophysiology of Multi-organ System Involvement

Pathophysiology of Multi-organ System Involvement

Pathophysiology characterized by vasospasm, platelet aggregation, and tissue ischemia involving hematologic, uteroplacental, hepatic, renal, and central nervous systems.

  • Vasospasm
  • Platelet aggregation/consumption
  • Tissue ischemia
  • Altered placental perfusion
  • Endothelial damage
  • Hemolysis
  • Hypoxia
  • IUGR
  • Abruption
  • Fetal Death
  • Elevated liver enzymes
  • Hepatic rupture
  • Decreased renal blood flow
  • Oliguria
  • Increased urine protein
  • Increased cerebrovascular resistance
  • CNS irritability
  • Hyperreflexia/clonus
  • Visual disturbances
  • Seizures

Pharmacologic Management of Preterm Labor

Pharmacologic Management of Preterm Labor

Pharmacologic management of preterm labor includes tocolytics, antenatal glucocorticoids, magnesium sulfate, terbutaline, nifedipine, and prostaglandin synthetase inhibitors.

  • Tocolytics
  • Antenatal Glucocorticoids
  • Betamethasone
  • Dexamethasone
  • Magnesium sulfate
  • Terbutaline
  • Indomethacin
  • Fetal lung maturity
  • Smooth muscle relaxation
  • Neuroprotection
  • Ductus arteriosus

Antepartal Nursing Assessment and Management

Vaginal and Bimanual Examination Techniques

Nursing assessment involves bimanual exam to palpate the enlarging uterus, clinical pelvimetry, vaginal exam, and cervical inspection.

  • Bimanual exam
  • Clinical pelvimetry
  • Vaginal exam
  • Speculum opening
  • Cervical inspection
  • Nulliparous cervical os
  • Multiparous cervical os

Chronic Conditions and Seizures in Pregnancy

Pregestational Diseases and Pregnancy Management

Management of obesity, systemic lupus erythematosus, multiple sclerosis, and seizure disorders during pregnancy.

  • Obesity in pregnancy risks
  • Systemic Lupus Erythematosus (SLE) characteristics
  • SLE maternal and fetal complications
  • SLE pharmacological treatments
  • Multiple Sclerosis and pregnancy stability
  • Seizure disorders and anticonvulsant use
  • Preconception counseling
  • Nutritional counseling

Management and Nursing Care of Preeclampsia and HELLP Syndrome

Management of Preeclampsia and HELLP Syndrome

Prevention, treatment, and nursing considerations for preeclampsia, eclampsia, and HELLP syndrome in pregnant and postpartum patients.

  • Low dose aspirin therapy
  • Preeclampsia prevention
  • Antihypertensive therapy
  • Hydralazine
  • Labetalol
  • Magnesium sulfate administration
  • MgSO4 toxicity monitoring
  • Eclampsia seizure management
  • HELLP syndrome laboratory markers
  • Hemolysis
  • Elevated liver enzymes
  • Low platelets
  • HELLP syndrome complications
  • Nursing assessments
  • Blood pressure monitoring
  • Postpartum follow-up

Diabetes Mellitus and Pregnancy Management

Diabetes Mellitus and Pregnancy Management

This content discusses pre-gestational and gestational diabetes mellitus, including maternal and fetal risks, screening via oral glucose tolerance tests, nutritional guidelines, and glucose monitoring.

  • Pre-gestational Diabetes Mellitus
  • Gestational Diabetes Mellitus
  • Maternal and Fetal Risks
  • Oral Glucose Tolerance Test (OGTT)
  • Nutritional Guidelines
  • Physical Activity
  • Oral Antihyperglycemic Therapy
  • Insulin Use
  • Glucose Monitoring
  • Labor Management
  • Postpartum Care

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