Teenage pregnancies - ANSWER -risk takers: smoking, drugs, alcohol, bad
nutrition, trying to hide pregnancy
-developmental task
-perinatal risks: little prenatal care
Cardiovascular disorders - ANSWER -major non-obstetric cause of maternal
death
-complication: cardiac decompensation; inc blood flow leads to CHF*
-incidence of miscarriage inc
-preterm labor & birth are more prevalent in pregnant women with cardiac
problems
-impeded or delayed development of fetus called IUGR is common (if blood
flow is compromised to mom, baby's blood flow is compromised as well)
Common causes of cardiac arrest - ANSWER -trauma
-cardiac abnormalities
-embolism
-magnesium overdose
-sepsis
,-intracranial hemorrhage
-anesthetic complications
-eclampsia
-uterine rupture
New York Heart Association - ANSWER -according to function limitations
placed on the individual because of the disease*
-functional limitations are imposed by the symptoms of the disease when the
heart is overburdened (cardiac decompensation) and cannot cope with the
activity
Class 1 - ANSWER -asymptomatic with normal activity*
-tx: prophylactic to prevent cardiac decompensation*
-increased PNC, prevent infections, rest 8-10 hrs/day, 30 min naps after
eating, SVD (vaginal delivery); forceps (prevents them from having to push)
Class 2 - ANSWER -symptomatic with inc activity*
-slight limitations of physical activity: avoid heavy exertion
-comfortable at rest
-moderate restriction of activity during pregnancy
-tx: same as class 1 except 2 weeks hospitalization prior to EDD, local or
regional anesthesia, O2, longer PP stay
, Class 3 - ANSWER -symptomatic with normal activity*
-marked limitations of physical activity
-comfortable at rest
-less than ordinary activities make them symptomatic (walking to bathroom
makes them have SOB)
-tx: bed rest for most of each day, if symptoms occur then hospitalization,
consider therapeutic abortion in 1st trimester, vaginal delivery desirable
-30% have cardiac decompensation
Class 4 - ANSWER -symptomatic with rest*
-"cardiac cripples"
-inability to carry on any physical activity without discomfort, even at rest
they may be symptomatic (sitting in chair and have labored breathing)
Intrapartum care - ANSWER -ABG's: assess oxygenation
-Swan-Ganz catheter: monitor hemodynamic status (measures pressure that
goes into R atrium)
-avoid hypotension
-penicillin prophylaxis for non-allergic class 2 or higher to protect against
bacterial endocarditis in labor or early PP*
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