Menopause
The transition from normal ovulatory cycles to cessation of menses is often referred to as this?
What is perimenopause
Beginning age a woman is more at risk for
osteoporosis
What is 50 years?
What are the two different types of menopausal hormonal therapy?
Estrogen replacement therapy-only estrogen; hormonal replacement therapy-contains estrogen and progestins.
What are two comfort measures for hot flashes and flushes during the day and two comfort measures at night
During the day:
Wear layered clothing, Avoid triggers, Splash face with cool water, try slow deep breathing
At night:
Sleep in cotton clothes, keep room cool, avoid heavy blankets, keep water by the bed
1. When patient with risk factors for gestational diabetes mellitus should be screened?
and
2. When patients without risk factors should be screened for gestational diabetes mellitus?
1. Prior to 24 weeks.
2. 24 to 28 weeks.
Describe menstrual changes during
perimenopause?
May have 2 to 3 days of spotting followed by 1 to
2 days of heavy bleeding, or they may have
regular menses followed by 2 to 3 days of
spotting
Body type and race of women more likely to have osteoporosis
What is small-boned, thin, and White or Asian
What are three alternative therapies a woman can use to alleviate menopausal symptoms?
acupuncture, herbal remedies, vitamin E, layered clothing, and homeopathy remedies
What are comfort measures for insomnia associated with menopause?
Avoid caffeine, alcohol and tobacco in the evening
avoid liquids after dinner
exercise regularly but limit to daytime and early evening
develop a bedtime routine
try warm milk or hot bath
use bed only for sleeping or sexual activity
encourage your body’s circadian rhythm
if you cannot sleep, get up and do something until you feel tired
avoid naps during the day
sprinkle lavender oil on the pillow
drink chamomile tea
What is intrapartum nursing care for client with gestational diabetes?
Glucose levels monitored every 1 to 2 hours to maintain euglycemia at 80-100 mg/dL
rapid-acting insulin infusions may be necessary to maintain euglycemia
Glucose control can often be achieved by using IV fluids without dextrose
What are the genital changes that occur during
perimenopause?
Vaginal membranes thin, hold less moisture, and
lubricate more slowly.
Reason obese women are at less risk for osteoporosis
What is higher estrogen levels from the conversion of androgens in adipose tissue and mechanical stress from extra weight helps to preserve bone mass.
What are risk factors for hyperemesis gravidarum?
What is younger maternal age, nulliparity, BMI less than 18.5 or greater than 25, and low socioeconomic status. Hx of asthma, migraines, preexisting diabetes, psychiatric illness, hyperthyroid disorders, gastrointestinal disorders, or previous pregnancy with hyperemesis gravidarum?
What are comfort measures for headaches associated with menopause?
Try to avoid stress and get plenty of rest
eat or drink foods that contain natural diuretics such as parsley
What is postpartum nursing care for client with gestational diabetes?
Exercise and a healthy diet can decrease risk for developing type 2 diabetes in the future
Women who have had GDM have up to 70% chance of developing type 2 diabetes within 10 to 20 years.
What causes hot flashes/flushes associated with menopause?
Fluctuating estrogen levels
Time of life of inadequate calcium intake that is a risk factor for osteoporosis
What is during adolescence and into the third and fourth decades?
What is the care priority for any pregnant woman with nausea and vomiting?
What is thorough assessment? (Frequency, severity, duration of N/V, precipitating and alleviating factors, pharmacologic or nonpharmacologic treatment, complete physical exam)
What are comfort measures for urogenital symptoms associated with menopause?
Drink lots of water (at least 8 glasses a day) and empty bladder frequently
practice Kegel exercises daily
wear cotton underwear and avoid wearing wet bathing suits for a prolonged time
use water soluble lubricants for vaginal dryness.
What are antepartum interventions for client with GDM for diet, exercise, and glucose monitoring?
Diet: carbohydrates are restricted to approximately 33% to 40% of calorie intake
Exercise: moderate exercise program for overweight or obese women to improve glucose control
Glucose monitoring: typical schedule is fasting and 1 or 2 hours after each meal
What are some mood and behavioral responses that may occur during perimenopause and menopause?
What are mood shifts, insomnia, fatigue from
loss of sleep, depressed mood, emotional
lability, nervousness, agitation, and less control of emotions?
Lifestyle choices that can help women prevent osteoporosis
What are weight bearing exercises, aerobics and strength training, increased calcium intake during the first 40 years of life?
What fetal complications associated with hyperemesis gravidarum?
What is small for gestational age, low birth weight, or premature birth?
What are comfort measures for nervousness/irritability associated with menopause?
Practice yoga or other meditation
do relaxation or deep-breathing exercises
practice guided imagery
What are antepartum interventions for client with GDM for pharmacologic management and fetal surveillance?
Pharmacologic management: some will require insulin for glucose regulation. Glyburide and Metformin (oral hypoglycemics) have been used in addition to diet for glucose control
Fetal surveillance: not routinely performed unless other risk factors such as HTN, prior stillbirth, or macrosomia. Twice weekly NSTs starting at 32 weeks if risk factors or on medication for diabetes.