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Essentials of Maternity, Newborn, and Women's Health Nursing, 4th Ed., Ricci, 2016
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20 - Nursing Management of Pregnancy at Risk: Selected Health Condtions and Vulnerable Populations

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Essentials of Maternity, Newborn, and Women's Health Nursing, 4th Ed., Ricci, 2016 | Registered Nurse (RN) School Study Aid

20 - Nursing Management of Pregnancy at Risk: Selected Health Condtions and Vulnerable Populations
50 Picmonics to Learn | 1 hr 37 mins
Hyperglycemia
Mechanism
Insulin Resistance
Too Little Insulin/Medication
Infection/Illness
Corticosteroids
Assessment
Elevated Blood Glucose
Polyphagia
Polydipsia
Polyuria
Hypotension
Fatigue/Drowsiness
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1 min
Hemoglobin A1c Lab Value
4-6%
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1 min
Glyburide and Glipizide (2nd Generation Sulfonylureas)
Mechanisms
2nd Generation Sulfonylureas
Blocks Potassium Channels in Beta Cells
Stimulate Release of Insulin
Indications
Type 2 Diabetes
Side Effects
Hypoglycemia
Considerations
More Potent
Beta Blockers Reduce Effects
Avoid Alcohol
Avoid Breastfeeding
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2 mins
Metformin (Glucophage)
Mechanism
Decrease Glucose Production
Increase Insulin Sensitivity
Indications
Type 2 Diabetes
Polycystic Ovary Syndrome (PCOS)
Side Effects
GI Distress
Decreased Appetite
Lactic Acidosis
Considerations
IV Contrast
Limit Alcohol Consumption
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2 mins
Mitral Regurgitation
Characteristics
Holosystolic
Blowing Murmur
Loudest at Apex
Radiates toward Axilla
Louder by Squatting
Hand Grip
Expiration
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1 min
Mitral Stenosis
Characteristics
Murmur Follows Opening Snap
Late Diastolic Murmur
Enhanced by Expiration
Low-Pitched Rumbling
Dilation of Left Atrium (LA)
Recurrent Attacks of Rheumatic Fever
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2 mins
Warfarin (Coumadin)
Mechanism of Action
Inhibits Clotting Factors
Indications
Atrial Fibrillation
Venous Thrombosis
Pulmonary Embolism
Assessment
PT/INR Levels
Observe for Bleeding
Contraindications
Pregnancy
Nursing Considerations
Vitamin K and Fresh Frozen Plasma
Prolonged Therapeutic Onset
Maintain Same Diet
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2 mins
Pregnant Cardiac Patient Interventions
Prenatal
Monitor for Cardiac Decompensation
Stool Softener
Calcium Channel Blockers
Labor
ECG Monitor
Open Glottis Pushing
Pulmonary Artery Catheter
No Beta-Adrenergic Medications
Penicillin Prophylaxis
Postpartum
Stress on Heart
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2 mins
Rheumatoid Arthritis Interventions
Lifestyle Modifications
Heat and Cold Applications
Therapeutic Exercise
Balance Rest and Activity
Drug Therapy
NSAIDs
DMARDs
Glucocorticoids
Considerations
PT/OT
Reconstructive Joint Surgery
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2 mins
Rubella TORCH
Signs and Symptoms
Nonspecific TORCH Symptoms
Patent Ductus Arteriosus
Pulmonary Artery Hypoplasia
Cataracts
Deafness
Blueberry Muffin Rash
Glaucoma
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1 min
Chlamydia
Mechanism
Chlamydia trachomatis
Assessment
May Be Asymptomatic
Dysuria
Epididymitis
Discharge
Dyspareunia
Interventions
Doxycycline
Azithromycin
No Intercourse for 1 Week
Treat Partners
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2 mins
Genital Herpes
Mechanism
Herpes Simplex Virus 1 and 2 (HSV)
Assessment
May Be Asymptomatic
Oral or Genital Lesions
Vesicles in Clusters
Pain
Flu-like Symptoms
Antiviral Medications
Acyclovir
Valacyclovir
Famciclovir
Considerations
Infectious During Recurrences
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2 mins
Syphilis
Mechanism
Treponema pallidum
Assessment
Primary Stage
Painless Chancre
Secondary Stage
Rash on Palms and Soles
(Generalized) Lymphadenopathy
Condylomata Lata
Latent Stage
Asymptomatic
Tertiary (Late) Stage
Aortitis
Neurosyphilis
Gummas
Interventions
Penicillin
Jarisch-Herxheimer Rash
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3 mins
Syphilis TORCH
Signs and Symptoms
Nonspecific TORCH Symptoms
Often Results in Stillbirth
Hydrops Fetalis
Saber Shins
Notched Teeth
Saddle Nose
Blindness
Deafness
Hepatitis
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3 mins
Gonorrhea
Mechanism
Neisseria gonorrhoeae
Assessment
Dysuria
Yellowish-Green Discharge
Increased Urinary Frequency
Women Often Asymptomatic
Interventions
Ceftriaxone (IM)
Chlamydia
Doxycycline
Azithromycin
Considerations
Treat Partners
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2 mins
Hepatitis B (HBV) Assessment
Transmission
Bodily Fluids
Blood Transmission
People Who Use IV Drugs
Incubation
Variable 1-6 Months
Assessment
Fever
Nausea and Vomiting
Hepatomegaly
Chronic Disease
Cirrhosis
Hepatocellular Carcinoma
Considerations
Vaccination
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2 mins
Alcohol Use Disorder Assessment (Formerly Alcohol Abuse Assessment)
Intoxication
CNS Depression
Withdrawal
Wernicke-Korsakoff Syndrome
Medical Complications
GI Distress
Cardiomyopathy
Pancreatitis
Cirrhosis
Immunosuppression
Sexual Dysfunction
Considerations
Screening (Assessments)
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3 mins
Alcohol Use Disorder Interventions (Formerly Alcohol Abuse Interventions)
Withdrawal
Reduce Environmental Stimuli
Antianxiety Medications
Vitamin Supplements
Seizure Precautions
Suicide Precautions
Fever
Considerations
Identify Support Systems
Group Therapy
Disulfiram
Naltrexone
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2 mins
Opioid Use Disorder and Withdrawal Assessment (Formerly Opioid Abuse and Withdrawal Assessment)
Abuse Assessment
Euphoria
Miosis
CNS Depression
Abuse Withdrawal
Yawning
Gooseflesh
Sweating
Rhinorrhea
Kicking Movements
Consideration
Naloxone
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1 min
Substance Use Disorder Assessment (Formerly Substance Abuse Assessment)
Changes in Mood
Poor Hygiene
Odd Sleep Patterns
Frequent Injuries
Relationship or Job Difficulty
Poor Performance
Anorexia OR Weight Loss
Social Isolation
Financial Problems
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2 mins
Varicella (Chickenpox)
Mechanism
Varicella Zoster Virus (VZV)
Signs and Symptoms
Red Maculopapular Rash
Vesicles Ooze and Crust
Pruritus
Centripetal
Considerations
Varicella Immunization
Skin Care to Minimize Itching
Isolate until Vesicles Crust
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2 mins
Diabetes Assessment
Assessment Type 1
Juvenile Onset
Absent Insulin Production
Ketosis Prone
Assessment Type 2
Adult Onset
Insulin Resistance
Obesity
Gestational Diabetes
Onset During Pregnancy
Glucose Intolerance
Complications
Retinopathy
Peripheral Vascular Disease
Nephropathy
Neuropathy
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2 mins
Oral Glucose Tolerance Test (OGTT)
Used for Diabetes Screening
Fasting State
Samples Drawn
Baseline
Normal < 100 mg/dL
30 and 60 Minutes
Normal < 200 mg/dL
120 Minutes
Normal < 140 mg/dL
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2 mins
Diabetes Education
Self-Monitoring (Blood Glucose)
SubQ Injection Technique
Lifestyle Changes
Symptoms of Hyperglycemia and Hypoglycemia
Sick Day Care
Foot Care
Exercise Therapy
Medication
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1 min
Insulin
Rapid Acting
Insulin Lispro (Humalog)
Insulin Aspart (Novolog)
Insulin Glulisine (Apidra)
Short Acting
Regular Insulin (Humulin R)
Intermediate Acting
Isophane NPH (Humulin N)
Long Acting
Detemir (Levemir)
Glargine (Lantus)
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2 mins
Pregnant Diabetic Patient Interventions
First Trimester
Increase Insulin then Decrease
Metformin
Nutrition
Exercise
Second Trimester
Increase Insulin
More Likely to Develop Hypoglycemia than Hyperglycemia
Third Trimester
Double or Quadruple Insulin
Early Delivery
Postpartum
Drastically Decrease Insulin
Monitor Neonate for Hypoglycemia
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3 mins
Diabetes Interventions
Early Diagnosis
Insulin
Oral Hypoglycemics
Glucose Monitoring
Routine Exercise
Diabetic Diet
Monitor for Complications
Insulin Therapy
Diabetic Ketoacidosis (DKA)
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2 mins
Hypoglycemia Assessment
Mechanism
Too much insulin
Decreased glucose
Assessment
< 70 mg/dL
Change in LOC
Lethargic
Confusion and Irritability
Tremors
Diaphoresis
Tachycardia
Vision Changes
Weakness
Seizures
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2 mins
Pregnant Cardiac Patient Assessment
Mechanism
Cardiac Decompensation
Signs and Symptoms
Frequent Cough
Dyspnea
Palpitations
Excessive Fatigue
Pulse > 100 bpm
Crackles
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2 mins
Patent Ductus Arteriosus
Continuous
Machine like murmur
Often Due to Congenital Rubella
Prematurity
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1 min
Aortic Stenosis
Characteristics
Age-related Calcifications
Bicuspid Aortic Valve
Crescendo-decrescendo Murmur
Systolic Murmur
Ejection Murmur
Ejection Click
Radiates to Carotids and Apex
Pulsus Parvus et Tardus
Syncope
Helmet Cells
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2 mins
Aortic Regurgitation
Auscultation
Diastolic Murmur
Immediate High-pitched
Blowing Murmur
Clinical Findings
Wide Pulse Pressure
Water Hammer Pulse
Head Bobbing
Pulsating Nail Bed
Considerations
Can Cause Austin Flint Murmur
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1 min
Tetralogy of Fallot (TOF)
Features
Blue Baby Syndrome
Mechanism
PROVe Acronym
Pulmonary Infundibular Stenosis
Right Ventricular Hypertrophy
Overriding Aorta
Ventricular Septal Defect (VSD)
Diagnosis and Treatment
Boot-Shaped Heart
Squatting for Tet Spells
Surgery
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2 mins
Asthma Assessment
Assessment
Triggers (Cold air, Dander, Dust, Infection, Mold, Pollen, Smoke)
Shortness of Breath (SOB)
Tachypnea and Tachycardia
Wheezing
Diaphoresis
Accessory Muscles
Decreased Pulmonary Function Tests
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2 mins
Asthma Implementation and Education
Medication
Oxygen
Corticosteroids
Ipratropium (Anticholinergic)
Albuterol
Implementation
Inhaler/nebulizer
Pulse Oximetry
Pursed Lip Breathing
Education
Carry Inhaler
Rinse Mouth after Inhaler
Identify Trigger (Cold Air, Dander, Dust, Infection, Mold, Pollen, Smoke)
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2 mins
Tuberculosis Skin Mantoux Test (PPD)
Delayed Hypersensitivity (Cell Mediated Response)
Intradermal Injection
Read 48-72 hours
Positive Results
≥ 5 mm Induration
Immunosuppressed
≥ 10 mm Induration
High Risk Patients
≥ 15 mm Induration
Considerations
Chest X-Ray
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3 mins
Tuberculosis Assessment
Etiology
Airborne Droplet
Assessment
3 Week Productive Cough
Night Sweats
Chest Pain
Fever
Weight Loss
Fatigue
Diagnosis
Chest X-Ray
Blood Tests
Mantoux Skin Test
3 Positive Sputum Tests
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1 min
Tuberculosis Intervention
Hospital Care
Airborne Isolation
Drug Therapy
Combination Drug Therapy (RIPE)
6-12 Months
Considerations
DOT
BCG Vaccination
Medication Education
3 Negative Sputum Specimens
Infection Control
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2 mins
Iron (Ferrous Sulfate)
Mechanism
Ferrous Salts
Indications
Anemia
Side Effects
GI Distress
Nausea and Vomiting
Dark Stools
Considerations
Take Between Meals
Liquid can Stain Teeth
Keep out of Reach from Children
Caution with GI Disorders
Avoid Antacids
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3 mins
Sickle Cell Anemia Assessment
Cause/Mechanism
Hemoglobin S (Genetic Defect)
Sickle Shaped RBCs
Assessment
Jaundice
Vaso Occlusive Crisis
Fever
Priapism
Severe Pain
Considerations
Prominent in African Americans
May be Asymptomatic
Increased Risk of Infection
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2 mins
Sickle Cell Anemia Interventions
Interventions
Increase Hydration
Analgesics
Oxygen
Warm Compress
Bone Marrow Transplant
Hydroxyurea
Considerations
Avoid High Altitudes
Prophylactic Antibiotics
Avoid Strenuous Exercise
Vaccines
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3 mins
Systemic Lupus Erythematosus (SLE) Assessment
Mechanism
Multisystem Inflammatory Disorder
Assessment
Malar Rash
Discoid Rash
Arrhythmias
Arthritis
Hemolytic Anemia
Seizures
Glomerulonephritis
Considerations
Periods of Exacerbation and Remission
Diagnosed by ANA (Anti-nuclear antibody assay)
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2 mins
Systemic Lupus Erythematosus (SLE) Interventions
Avoid Sunlight
Drug Therapy
Glucocorticoids
Methotrexate
NSAIDs
Hydroxychloroquine
Azathioprine
Considerations
Monitor for Renal Failure (ARF)
Manage Pain
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2 mins
Multiple Sclerosis Assessment
Cause/Mechanism
Nerve Fiber Demyelination
Assessment
Motor Issues
Cerebellar Signs
Fatigue
Paresthesias
Spasticity
Urinary Incontinence
Optic Neuritis
Considerations
Women Between 20-50 Years Old
Relapse and Remission of Symptoms
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2 mins
Multiple Sclerosis Interventions
Drug Therapy
Corticosteroids
Interferon Beta
Dimethyl Fumarate (Tecfidera)
Fingolimod (Gilenya)
Mitoxantrone (Novantrone)
Natalizumab (Tysabri)
Considerations
Increase Exercise
Identify Triggers
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2 mins
Cytomegalovirus (CMV) TORCH
Signs and Symptoms
Nonspecific TORCH symptoms
Intrauterine Growth Restriction (Retardation)
Deafness
Microcephaly
Seizures
Periventricular Calcifications
Petechial Rash
Blueberry Muffin Rash
Chorioretinitis
Diagnosis
Urine Viral Culture or PCR
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2 mins
Rubella
Mechanism
Rubella Virus
Signs and Symptoms
Swollen Glands
Cold-like Symptoms
Pinkish-red Maculopapular Rash
Low Grade Fever
Considerations
Rubella Titer
Avoid Contact with Pregnant Women
MMR Vaccination
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2 mins
Toxoplasma gondii TORCH
Signs and Symptoms
Congenital TORCH Infection
Mom Usually Asymptomatic
Rarely Lymphadenopathy
Nonspecific TORCH Signs
Intrauterine Growth Retardation
Hepatosplenomegaly
Deafness
Chorioretinitis
Hydrocephalus
Diagnosis
Calcifications
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1 min
Cocaine Intoxication Assessment
Euphoria
Delusions
Mydriasis
Hallucinations
Agitation
Hypertension
Arrhythmias
Hyperthermia
Seizures
Nasal Septum Perforation
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2 mins
Marijuana Intoxication Assessment
Euphoria
Slowed Reaction Time
Conjunctival Injection
Increased Appetite
Anxiety
Social Withdrawal
Paranoid Delusions
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2 mins

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