Loading presentation...

Present Remotely

Send the link below via email or IM

Copy

Present to your audience

Start remote presentation

  • Invited audience members will follow you as you navigate and present
  • People invited to a presentation do not need a Prezi account
  • This link expires 10 minutes after you close the presentation
  • A maximum of 30 users can follow your presentation
  • Learn more about this feature in our knowledge base article

Do you really want to delete this prezi?

Neither you, nor the coeditors you shared it with will be able to recover it again.

DeleteCancel

Make your likes visible on Facebook?

Connect your Facebook account to Prezi and let your likes appear on your timeline.
You can change this under Settings & Account at any time.

No, thanks

Pregnancy at Risk: Pregestational conditions

No description
by

Keyshawnna Pittman

on 9 September 2014

Comments (0)

Please log in to add your comment.

Report abuse

Transcript of Pregnancy at Risk: Pregestational conditions

Substance Abuse
CREDITS
"A Woman's Right To Know Information Material" BOOKLET
Pregnancy At Risk: Pregestational Problems
Cocaine/Crack
Blocks the reuptake of dopamine
Marijuana
Most commonly abused illicit drug
No evidence of teratogenic effects on fetus
May cause withdrawal symptoms after delivery.
Crystal Meth
Synthetic stimulant
Increases dopamine in the brain
Maternal effects:
Tachycardia, vasoconstriction, hypertension
Spontaneous abortions, placental abruption
Fetal effects:
Premature birth, low birth weight
Cleft palate, abnormal brain development

Carbohydrate Metabolism
Too little glucose is produced
Cells become glucose resistant
During Pregnancy
Clinical Manifestations
The Polys
Screening and Treatment
Screening at 24-28 weeks gestation for average risk individuals
Test: 1-hour GTT (glucose tolerance test)
3 hour oral GTT
Positive diagnosis of GDM is made when two or more values are met or exceeded

Screening and Treatment
Good prenatal care
Diet control
Glucose monitoring
Insulin Therapy
Evaluation of fetal status
AFP, NST, Ultrasounds
Elective delivery
C-section
Diabetes
Mellitus

HIV Infections
Human immunodeficiency virus
Transmitted through blood, blood products or other body fluids
Decreases the body’s immune response

What it is...
Risks......
IV drug use
History of multiple sex partners
History of sexually transmitted infections
Bisexual/homosexual partner

Clinical Therapy
HIV Infection
Screening
Antiretroviral therapy
Evaluation and treatment for other conditions
Monitor disease progression and complications
High risk pregnancy requires close monitoring
Intrapartum management
Education

Nursing Considerations
Education/prevention
Screening
Medication management
Psychological implications
Cardiovascular
Disease
Antepartum
Peak hemodynamic changes occur between 28-32 weeks
Treat diagnoses that are causing stress
Teach patient and family s/s of problems
Provide nutritional counseling with family present
Increase fiber intake

Intrapartum
Routine labor assessments
Arterial blood gases
A Swan-Ganz catheter
ECG monitoring
Continuous blood pressure and pulse oximetry
Continuous fetal monitoring
Minimize anxiety!!!
Keep head and shoulders elevated/sidelying
Medications for pain relief

Postpartum
First 24-48 hours is the most unstable time
Vital signs
Pulse oximetry
Lung and heart auscultation
Edema
Bleeding assessment
Uterine tone
Urinary output
Dietary intake
Mother-infant bonding
Emotional state
Activity-rest pattern

Phases of Care
information was taken from...
"The First 9 Months" BOOKLET by Vivki L. Dihle, PA-C Bradley G. Beck, M.D.
The STD Project: A Positive Voice Website by Janelle Marie
Just the facts.......
1 in 6 women smoke during pregnancy.
Nearly 10% of women admit to drinking while pregnant.
More than 5% of women report use of illicit drugs during pregnancy.
Maternal Effects: Tachycardia
hypertension, seizures
Fetal Effects: Prematurity,
behavioral problems, irritability

Heroin/Methadone


Opioid similar to cocaine
Produces euphoria
Maternal effects
Poor nutrition, anemia, preeclampsia
Higher incidence of STDS
Fetal effects
Low birth weight, small head circumference, prematurity
Restlessness, inconsolable crying, seizures
Methodone is used as therapy for opioid addiction


Prescription Drugs


Commonly Abused
Opiates (Oxycontin, Demerol, codeine)
CNS depressants (Xanax, Valium)
Stimulants (Ritalin)
Maternal/Fetal effects
Remember pregnancy categories
Decreased placenta perfusion
Birth defects
Stillbirth, miscarriage

Early Pregnancy: increased levels of estrogen, progesterone, and other hormones stimulate increased insulin production

Second half of Pregnancy: Placental secretion of human placental lactogen and prolactin cause an increase resistance to insulin and decreased glucose tolerance

Maternal And Fetal Risks


Maternal:
Hydramnios
Preeclampsia
Urinary tract infections
Fetal:
Macrosomia
Birth trauma
Hypoglycemia
Death



Intrapartum/ Postpartum Management
Decreased insulin needs during labor
Glucose checks every 2 hours
Decreased insulin needs after birth
IF IT'S WET AND NOT YOURS PLEASE USE PPE!!!!
Focused on minimizing stress on the heart
Approximately 1% of pregnant women of childbearing age have preexisting heart disease
Leading cause of non-obstetric maternal mortality
Rheumatic fever is the leading cause of cardiac complications
Other types include mitral valve disease and congenital causes
Peripartum cardiomyopathy
Many changes that put strain on the heart:
increased intravascular volume
decreased systemic vascular resistance
cardiac output changes during labor and birth
major intravascular changes after delivery



Cardiovascular Disease in Pregnancy

Cardiovascular Disease
Classification by degree of disability
-Class I
-Class II
-Class III
-Class IV

Care and Management
Multidisciplinary Approach!!!!!
Offer support and teaching based on learning needs
Interview
personal/familial medical history
ROS
Medications presently taking
Social questioning
Physical Exam
Laboratory and Diagnostic Testing

Vitamins and Iron
Anticoagulant
Heparin
Diuretic
Lasix for congestive heart failure
Glycosides
Digitalis

Drug Therapy

Associated Risks

Maternal:
Antiretroviral therapy
Opportunistic infection
Fetal:
ART
Neonatal Transmissio
Full transcript