NU 335 Maternity Chapter 17 Pregnancy at Risk:
Pregestational Problems /31 Questions And Answers
Graded (A+)
Quiz :What is the pathophysiology of Diabetes Mellitus? - √Answer :Endocrine
disorder of carbohydrate metabolism
-results from inadequate production or utilization of insulin
-cellular and extracellular dehydration
-body cells depleted
-breakdown of fat and proteins for energy
Quiz :What are the 4 cardinal signs and symptoms of Diabetes Mellitus? -
√Answer :1. Polyuria
2. Polydipsia
3. Polyphagia
4. Weight loss
Quiz :What are the 3 types of Diabetes Mellitus and how are each classified? -
√Answer :1. Type I Diabetes Mellitus (DM)
-obtained at birth
2. Type II DM
-obtained later in life
3. Gestational Diabetes Mellitus (GDM)
-glucose intolerance of variable severity with onset or first recognition during
pregnancy
Quiz :What are the profound changes in CHO, protein, and fat metabolism in
pregnancy mediate by? - √Answer :1. Developing fetus
2. Production of placental hormones
Quiz :How is glucose metabolism affected during the first half of pregnancy? -
√Answer :Anabolic phase
-increasing maternal hormones increase the demand for insulin production to
facilitate increased storage of glycogen in maternal tissue
Quiz :How is glucose metabolism affected during the second half of pregnancy?
- √Answer :Catabolic phase
-hPl from the placenta causes resistance to the action of maternal insulin
-this increases circulating glucose for fetal use and increases demand on the
maternal pancreas to produce more insulin
, -leads to altered CHO metbolism and progressive hyperglycemia (in those who
can't meet increasing demands of insulin production)
-ketones in urine as a result of lipolysis
Quiz :What is the influence of pregnancy on diabetes? - √Answer :1.
Physiologic changes of pregnancy alter insulin requirements
2. Accelerates progress of vascular disease
3. More difficult to control pregnancy
4. Primary concern is control of blood glucose levels (IMPORTANT)
Quiz :Why are we concerned more with Type I diabetics when it comes to
pregnancy? - √Answer :Uncontrolled Diabetes Mellitus can affect small vessels
-placenta is full of small vessels
-leads to high risk pregnancy if not controlled
Quiz :If the mother has hyperglycemia, how does the fetus respond? -
√Answer :The fetus develops hyperglycemia as well
-fetus produces its own insulin to treat its hyperglycemia
-fetus's insulin can't help the mother's hyperglycemia because it can't cross the
placental barrier (molecule is too big)
Quiz :What are the maternal risks of Diabetes Mellitus with pregnancy? -
√Answer :1. Hydramnios (too much amniotic fluid)
2. Preeclampsia-eclampsia
3. Hyperglycemia and ketoacidosis
4. Dystocia (difficult labor and delivery)
5. Increased susceptibility to infections
6. Worsening retinopathy
7. Spontaneous abortions
8. Preterm labor
Quiz :What are the fetal-neonatal risks of Diabetes Mellitus with pregnancy? -
√Answer :1. Perinatal mortality
2. Congenital abnormalities
3. Macrosomia (large baby)
4. IUGR (Intrauterine Growth Restriction = small baby)
-usually with Type I mothers
5. Respiratory Distress Syndrome (RDS)
6. Polycythemia
7. Hyperbilirubinemia, Hypocacemia (from polycythemia)
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