NCMA 219- Chapter 20 Nursing Care of a Family Experiencing Pregnancy Complications Q&A
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Course
NCMA 219
Institution
NCMA 219
Nursing care for the well, pregnant woman focuses on preventing illness by promoting an especially healthy lifestyle. When accidents and illness occurs despite these safeguards, nursing care focuses on: • Preventing such disorders from affecting the health of the fetus
• Helping a woman regain...
NCMA 219- Chapter 20 Nursing Care of a
Family Experiencing Pregnancy
Complications Q&A
Nursing care for the well, pregnant woman focuses on preventing illness by promoting
an especially healthy lifestyle. When accidents and illness occurs despite these
safeguards, nursing care focuses on: ✅• Preventing such disorders from affecting the
health of the fetus
• Helping a woman regain her health as quickly as possible so she can continue a
healthy pregnancy and prepare herself psychologically and physically for labor and birth
and the arrival of her newborn
• Helping a woman learn more about her chronic illness so she can continue to
safeguard her health during her childrearing years
Several National Health Goals are aimed at reducing complications of pregnancy that
arise from existing or newly acquired disorders. These goals are: ✅• Reduce the rate
of fetal deaths to 4.1 per 1000 live births from a baseline of 6.8 per 1000.
• Reduce the rate of maternal deaths to 3.3 per 100,000 live births from a baseline of
7.1 per 100,000.
• Reduce the rate of maternal illness and complications during pregnancy to 24 per 100
births from a baseline of 31.2 per 100
high-risk pregnancy ✅Is one in which a concurrent disorder, pregnancy-related
complication, or external factor jeopardizes the health of the woman, the fetus, or both.
The pregnancy of a woman who is DIABETIC ✅automatically termed one with greater
than normal risk because it forces a fetus to grow in an environment in which
hyperglycemia (increased serum glucose levels) becomes the rule.
"high risk" ✅rarely refers to just one causative factor helps in the planning of holistic
and ultimately effective nursing care.
,valve damage ✅The cardiovascular disorders that most commonly cause difficulty
during pregnancy are ________ caused by rheumatic fever or Kawasaki disease and
congenital anomalies such as atrial septal defect or uncorrected coarctation of the
aorta.
Aortic dilatation ✅may occur from Marfan's syndrome and also be a concern (Chaffins,
2007).
before conception ✅a woman should visit her obstetrician or family physician
___________ _________ so the health care team can become familiar with her state of
health when she is not pregnant and establish baseline evaluations of her heart
function, such as with an echocardiogram (Hameed & Akhter, 2007).
1 week after the first missed menstrual period ✅A woman should begin prenatal care
as soon as she suspects she is pregnant so that her general condition and circulatory
system can be monitored (Mooney, 2007).
8 weeks ✅Pregnancy taxes the circulatory system of every woman, even without
cardiac disease, because both the blood volume and cardiac output increase
approximately 30% (perhaps as much as 50%). Half of this increase occurs by ____
weeks; it is maximized by mid pregnancy.
Kawasaki disease or rheumatic fever ✅Women who had ___________ as a child may
have both valvular and aortic artery constrictions that lead to true valve dysfunction and
organic murmurs (Hibbard, Fajardo, & Briller, 2007).
28-32 weeks ✅The danger of pregnancy in a woman with cardiac disease occurs
primarily because of the increase in circulatory volume. The most dangerous time for a
woman is in weeks ______, just after the blood volume peaks. However, if heart
disease is severe, symptoms can occur as early as the beginning of pregnancy
TRUE
a woman with artificial but well-functioning heart valves can be expected to complete a
pregnancy without difficulty as long as she has consistent prenatal and postpartum
care. A woman with a pacemaker implant can also expect to complete pregnancy
successfully. Even women who have had heart transplants can be expected to have
successful pregnancies (Sibanda et al., 2007). ✅The estimation of whether a woman
with cardiovascular disease can complete a pregnancy successfully or not depends on
the type and extent of her disease.
TRUE/FALSE
a woman with artificial but well-functioning heart valves, can be expected to complete a
pregnancy without difficulty as long as she has consistent prenatal and postpartum
care.
,1. class I or II
2. Class III
3. CLASS IV ✅To predict pregnancy outcome, heart disease is divided into four
categories based on criteria established by the New York State Heart Association.
1. A woman with ______heart disease can expect to experience a normal pregnancy
and birth.
2. Women with ______can complete a pregnancy by maintaining almost complete bed
rest.
3. Women with ______heart disease are poor candidates for pregnancy because they
are in cardiac failure even at rest and when they are not pregnant. They are usually
advised to avoid pregnancy
CLASS 1 ✅CLASSIFICATION OF HEART DISEASE
Uncompromised. Ordinary physical activity causes no discomfort. No symptoms of
cardiac insufficiency and no anginal pain
CLASS II ✅CLASSIFICATION OF HEART DISEASE
Slightly compromised. Ordinary physical activity causes excessive fatigue, palpitation,
and dyspnea or anginal pain.
CLASS III ✅CLASSIFICATION OF HEART DISEASE
Markedly compromised. During less than ordinary activity, woman experiences
excessive fatigue, palpitations, dyspnea, or anginal pain
CLASS IV ✅CLASSIFICATION OF HEART DISEASE
Severely compromised. Woman is unable to carry out any physical activity without
experiencing discomfort. Even at rest symptoms of cardiac insufficiency or anginal pain
are present.
mitral stenosis, mitral insufficiency, and aortic coarctation ✅Left-sided heart failure
occurs in conditions such as???
Left-sided heart failure ✅the left ventricle cannot move the volume of blood forward
that it has received by the left atrium from the pulmonary circulation. The heart becomes
so overwhelmed it fails to function. The reason for the failure is most often at the level of
the mitral valve.
, Pulmonary edema ✅produces profound dyspnea as it interferes with oxygen-carbon
dioxide exchange as the fluid coats the alveolar exchange space (Bashore & Granger,
2009).
chest and head elevated (orthopnea).
* Elevating her chest allows fluid to settle to the bottom of her lungs and frees space for
gas exchange. ✅As pulmonary edema becomes severe, a woman cannot sleep in any
position except with her ________.
paroxysmal nocturnal dyspnea ✅suddenly waking at night short of breath. This occurs
because heart action is more effective when she is at rest. With the more effective heart
action, interstitial fluid returns to the circulation. This overburdens the circulation,
causing increased left-side failure and increased pulmonary edema
1. D
2. B
3. C
4. B
5. B ✅1. What are some conditions that can lead to left-sided heart failure?
a. Mitral stenosis
b. Aortic coarctation
c. Mitral insufficiency
d. All of the above
2. In left-sided heart failure, which ventricle is primarily affected?
a. Right ventricle
b. Left ventricle
c. Both ventricles equally
d. Atria
3. What is the role of the mitral valve in left-sided heart failure?
a. Facilitating blood flow to the lungs
b. Preventing back-pressure on the pulmonary circulation
c. Pushing blood forward from the left atrium
d. None of the above
4. How does pregnancy affect the mitral valve in the context of left-sided heart failure?
a. Prolongs diastole
b. Shortens diastole
c. Decreases cardiac output
d. None of the above
5. What is the consequence of the mitral valve's inability to push blood forward?
a. Increased cardiac output
b. Back-pressure on the pulmonary circulation
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