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NUR 406 ( LATEST 2024 / 2025 ) EXAM 15 | A++ EXAM WITH ALL NEW QS & AS - GUARANTEED PASS!
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NUR 406 ( LATEST 2024 / 2025 ) EXAM 15 | A++ EXAM WITH ALL NEW QS & AS - GUARANTEED PASS!
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NUR 406 Exam 151. dynamics of high-risk pregnancy- closely interwoven relationships of four factors
Answer
physiology of pregnancy, pathology of the complication, psychology of pregnancy, psychology
of illness
2. in a normal women's pregnancy, increased insulin resistance begins in 2nd half of pregnancy
Answer
the placenta produces increased amounts of human placental lactogen, estrogen, progesterone,
and other hormones
hormones cause increased resistance to insulin
maternal insulin demands rise as much as threefold (thought to be related to a combination of
hormonal antagonism to insulin and placental degradation of insulin)
3. in a diabetic pregnant woman
Answer
unable to increase production of insulin, pan- creas unable to produce sufficient insulin, insulin
not being used effectively
fails to meet the "diabetogenic" stress of the advancing pregnancy
especially complicating in the late 2nd and 3rd trimesters when insulin demands increase
4. without adequate insulin
Answer
glucose circulates in the blood stream, unable to enter the cells
the energy-starved cells catabolize fats and proteins for energy causing; ketosis from fat wasting,
negative nitrogen balance from protein breakdown and muscle tissue wasting
5. 1 hr GTT
Answer
done between 24-28 weeks, oral glucose test, in the office, anytime of day, nonfasting, 50g
6. 3 hr GCT
,Answer
done if is 1 hr GTT was abnormal, do after 3 days of 150g CHO and overnight fast
130-140 mg/dl
screen late 1st trimester if hx of insulin resistance, age >40, prior stillbirth, miscar- riage or
macrosomic or malformed infant
instruct pt to eat high CHO diet for three days and then fast overnight
7. management of diabetes
Answer
strict regulation of maternal glucose levels is essential to optimal perinatal outcome
insulin is usually the drug of choice in continuing or initiating glycemic therapy during pregnancy
carefully review oral hypoglycemic agents as some are contraindicated in pregnancy main goal is
dietary control
blood glucose should remain between 70-100 mg/dl after fasting and <120 mg/dl 2 hrs p meals
8. monitor fetal activity for diabetic patient
Answer
starting at 28 weeks
9. assess fetal growth with ultrasound for diabetic patient
Answer
18 and 28 weeks
10. offer serum alpha fetoprotein screening for diabetic patient
Answer
16-20 weeks
11. nonstress test in diabetic patient
Answer
starting at 28 weeks, done weekly twice weekly at 32 weeks
if nonreactive, biophysical profile done
, 12. most common medical disorder of pregnancy
Answer
anemia
13. hemodilution
Answer
physiologic anemia of pregnancy
14. amount of ferrous sulfate supplement needed
Answer
30-60 mg/day between meals with orange juice
15. problems caused by lack of iron supplements
Answer
maternal risk for infection and pp hemorrhage, fetal/neonatal risk for prematurity, stillborns,
SGA, hypoxia during labor, neonatal death
16. class 1 cardiac disease
Answer
asymptomatic at normal levels of activity, no limitations of physical activity, no symptoms of
cardiac insufficiency
17. class 2 cardiac disease
Answer
symptomatic with increased levels of activity, slight limitation on physical activity causes
fatigue, dyspnea, palpitations, and/or anginal pain
18. class 3 cardiac disease
Answer
symptomatic with normal levels of activity; moderate to marked limitations on physical
activity, comfortable at rest but less than ordinary physical activity causes fatigue, dyspnea,
anginal pain or palpitations
19. class 4 cardiac disease
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