Question

3. What is the treatment for preeclampsia, during labor? 4. What major conditions in the fetus and mother can result when the pregnant mother has preeclampsia? Diabetes (Endocrine and Metabolic Disorders) 1. Define: Gestational Diabetes Fill in: Pre-gestational diabetes mellitus is the term used for a woman that had diabetes before pregnancy.* 2. a. What are the biggest risk factors the nurse must look out for in the fetus of a diabetic mom? b. What is one the most important things to assess in the newborn of a diabetic mom after delivery?

Answer 1

3. Treatment for preeclampsia during labor :-

Treatment of mild preeclampsia in healthy women Any of the following present? • 37 weeks' gestation or more . Nonreassuring fetal status • Maternal indication for delivery • Labor or membrane rupture at 34 weeks or more Delivery Yes No Any of the following present? . 23-32 weeks' gestation • Unreliable patient . Systolic pressure > 150 mm Hg • Diastolic pressure > 100 mm Hg • Proteinuria >1 g/24 hours • Maternal symptoms Hospitalization Yes No In-hospital or ambulatory management Maternal-fetal evaluation

#. Mild hypertension (blood pressure 140/90-149/99 mmHg)

• Do not treat mild hypertension.

• Measure blood pressure at least 4 times a day.

• Test kidney function, electrolytes, FBC, transaminases and bilirubin 2 times a week.

#..Moderate hypertension (blood pressure 150/100-159/109 mmHg)

• Treat moderate hypertension with first-line oral labetalol to keep blood pressure below 150/80-100 mmHg. Offer treatment other than labetalol only after considering side-effect profiles for the woman, fetus and newborn baby. Alternatives include methyldopa and nifedipine.

• Measure blood pressure at least 4 times a day.

• Test kidney function, electrolytes, FBC, transaminases and bilirubin 3 times a week.

#. Severe hypertension (blood pressure 160/110 mmHg or higher)

• Admit women with severe hypertension to hospital until blood pressure is 159/109 mmHg or lower.

• Do not offer bed rest in hospital.

• Treat with first-line oral labetalol to keep blood pressure below 150/80-100 mmHg. Offer treatment other than labetalol only after considering side-effect profiles for the woman, fetus and newborn baby. Alternatives include methyldopa and nifedipine.

• Measure blood pressure at least 4 times a day.

• Test for proteinuria daily using an automated reagent-strip reading device or urinary protein:creatinine ratio.

• Test kidney function, electrolytes, FBC, transaminases and bilirubin at presentation and then monitor weekly.

4. Major conditions in the mother due to preeclampsia are :-

Decreased perfusion to organs.

Systemic vasospasms

Vascular damage

Coagulation abnormalities

HELLP syndrome :-

Hemolysis

Elevated Liver enzymes

Low Platelet count

Renal failure

Abruptio placentae

DIC (dissemination intravascular coagulation)

Ruptured Liver

Pulmonary edema/embolism

Cerebral edema/hemorrhage

#. Fetal risks

SGA

Fetal hypoxia

Prematurity

Oversedation at birth due to Magnesium to mother

1. Defination of gestational diabetes :-

Glucose intolerance that begins or is first recognized in pregnancy is called gestational diabetes and it is characterized by peripheral insulin resistance and declining beta cell functions- similar to type 2 diabetes

Fill up - Pre - gestational diabetes mellitus is the term used for a woman that had diabetes before pregnancy .

2a. Main risk factors the nurse must look out for in the fetus of a diabetic mother :-

- macrosomia

- hypoglycemia

2b. One of the most important thing to assess in the newborn of a diabetic mother after delivery is to assess the blood sugar of the newborn to rule out hypoglycemia . Babies born to diabetic mother have hypoglycemia .