Chapter 20
What are the norms for fasting blood glucose, HbA1c, and random glucose reading at 1st prenatal visit
Fasting 126
HgA1c <7%
Random 200
When does HpL stop rising
last 20 weeks of pregnancy
this is monitored during the pregnancy of a mother with gestational diabetes
urine: ketones
creatinine clearance
eye exam
fitness: 30minute intervals/ 3x per week
which foods are high in Fe
page 719 nursing management
these are the areas that the immune system will attack in patients with SLE
Cardiovascular
Skin
Musculoskeletal
nervous
Kidney
Lungs
When is an oral glucose tolerance test completed and what are the norms for the 1st OGTT
completed at 24-28 weeks gestation
Fasting: 92
75g OGTT 1hr: 180
75g OGTT 2 hr: 153
why is a diabetic mother at risk for hydramnios (what is hydramnios and how does diabetes affect the fetus in utero)
fetal diuresis due to increased glucose from mom
know the other risk factors for maternal and fetal. (why would a neonate be hypoglycemic at birth or within the 1st 24 hours?)
these foods interfere with iron absorption
coffee
tea
chocolate
high fiber
milk
what is monitored with thalassemia major (beta) mother's during pregnancy
Hgb and ferritin levels
must be followed by a cardiologist
why are mothers at high risk for infections with SLE
the suppressed immune system. Mainly UTIs and URIs (urinary and upper respiratory infections)
This is ordered if the mother fails the 2 hr OGTT
3 hr OGTT
1st hr: 180
2nd hr: 153
3rd hr: 140
all diabetic mothers receive this treatment when they are admitted to the L& D unit in active labor.
PIV with lactated ringers or N/S
50ml D50W (50% dextrose in water) at the bedside
hourly vitals with glucose check
This helps promote Fe absorption
vitamin C
take Fe on an empty stomach if tolerated
what is the treatment for mothers in sickle cell crisis
blood transfusion (severe anemia)
analgesics (for pain)
antibiotics (for infection)
this can cause an exasterbation of SLE
pregnancy
the greatest risk for active lupus nephritis (attacking the kidneys)
when is a mother with gestational diabetes blood glucose the highest
postprandial (after food)
this is why the OGTT is completed 1-2 hrs after ingestion of high glucose drink.
this medication treats gestational diabetes and does not cross the blood placental barrier
insulin
usually short-acting (regular) and intermediate (NPH)
this is seen with iron deficiency anemia. It is the craving for nonfood substances
PICA
what is the signs and symptoms of sickle cell crisis
severe abdominal pain
muscle spasms
leg and joint pain
fever
stiff neck
n/v
seizures
this is the treatment for SLE
NSAIDS
Prednisone
hydroxychloroquine
which hormone is responsible for increasing insulin resistance in pregnancy
HpL Human placental Lactogen
be able to explain how this works
how often are the HgA1c checked in mothers with gestational diabetes
every 4-6 weeks
What lab results indicates Fe deficiency anemia
Hgb <11
Hct <35%
Fe <30
this disease is autoimmune. antibodies form and they attack the body's cells and protein. It also suppresses the immune system allowing damage to the body tissue.
(hint: and my favorite moment from last class, Trick Daddy)
Systemic Lupus Erythematosus
this is the demyelination of the CNS
multiple scleorsis
Tx: NSAIDS