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Pregnancy
Pregnancy
Polyhydramnios
if CPD, C/S delivery
Possible complications Congenital anomalies
Macrosomia
For the mother, Vascular narrowing (Kidney, heart and
retinal dysfunction)
3. Substance Abuse
Brief Description of the condition Inability to meet major role obligations, an increase in legal
problems or risk-taking behavior, or exposure to hazardous
situations because of an addicting substance
Predisposing and Precipitating Factors Low level of education
poverty
Unmarried status
Tobacco use
Unemployment
S/Sx behaviors and presentations
o sedation, inebriation, disorientation,
depression, or memory loss
o euphoria, irritability, agitation,
aggressiveness or violent behavior,
paranoia, increased physical activity,
anxiety, nervousness, or panic
o prescription drug seeking behavior
o suicidal attempts or ideation
o psychosis or erratic behavior
symptoms
o hallucinations, panic, anxiety
o skin conditions such as abscesses, dry or
itchy skin, acne type sores
physical signs
o markedly dilated or constricted pupils, rapid
eye movements, or nystagmus
o tremors, increased pulse and blood
pressure, or increased body temperature
o weight loss with low BMI, malnutrition, or
hair loss
o track marks or injection site abscesses,
inflamed or eroded nasal mucosa, nose
bleeds, gum or peridontal disease including
broken teeth, severe decay, or infections
lab signs
o anemia
o hepatitis C infection
o positive sexually transmitted infection test
(retest in third trimester if at risk)
o mean corpuscular volume > 95
o elevated mean corpuscular hemoglobin,
gamma-glutamyl transpeptidase, serum
glutamic oxaloacetic transaminase, bilirubin,
or triglycerides
medical history including
o frequent hospitalizations, frequent falls,
unexplained bruises
o gunshot or knife wound
o unusual infections such as cellulitis,
endocarditis, atypical pneumonias, or HIV
o cirrhosis, hepatitis, or pancreatitis
o chronic mental illness
4. HIV/AIDS
Brief Description of the condition Disease that damages the immune system due to a virus
Predisposing and Precipitating Factors Unhealthy sexual habits
Drug use
Poverty
S/Sx Fatigue
Anemia
Diarrhea
Weight loss
Flu-like symptoms
Lab & Dx Procedures CBC
Kidney function test
Liver panel
HIV antibody test
CD4 T-cell count
HIV plasma RNA levels
HIV genotypic resistance
STI screening
Serologic screening
Ultrasound
ELISA antibody reaction
Western blot analysis
Effects to pregnancy and baby Baby
Pregnancy
C/S delivery
Possible complications
Nx Dx Risk for infection (opportunistic) r/t dysfunction of the
immune system secondary to invasion of HIV
Nx mgmt
Medical mgmt Acyclovir
Pyrimethamine
Sulfadiazine
Trimethoprim
Sulfamethoxazole
Amniocentesis
5. Rh Sensitization
Brief Description of the condition A phenomenon where the antibodies of the Rh-negative
mother are attacking the Rh-positive fetus.
Predisposing and Precipitating Factors Rh (-) mother and Rh (+) baby
S/Sx Blood type incompatibility problems
Fetal infections
Lab & Dx Procedures Doppler velocity ultrasound
Cord blood sampling
Amniocentesis
Effects to pregnancy and baby Pregnancy
May increase risk for anemia
May require tocolytic therapy if fetus is younger than 34
wks.
Early induction of labor
Direct transfusion of packed RBC
Baby
Risk for anemia or jaundice
Heart failure
Enlarged liver
Respiratory distress
Purpura
Kernicterus
Possible complications Hemolytic Disease of the Newborn
Miscarriage
Nx Dx
Nx mgmt
Medical mgmt RhoGAM
Intrauterine fetal blood transfusion
Aggressive hydration
Phorotherapy
6. Anemia
Brief Description of the condition The condition of having a lower-than-normal number of red
blood cells or quantity of hemoglobin
Predisposing and Precipitating Factors Multiple pregnancy
Hyperemesis
Early pregnancy
Diet low in iron
Unwise weight-reducing programs
Low socioeconomic levels
Are pregnant with multiples (more than one child)
Have had two pregnancies close together
Vomit a lot because of morning sickness
Are a pregnant teenager
Don't eat enough foods that are rich in iron
Had anemia before you became pregnant
S/Sx Pale skin, lips, and nails
Fatigue
Dizziness
Shortness of breath
Rapid heartbeat
Trouble concentrating
Restless leg syndrome
Pica
Lab & Dx Procedures Blood Test
Sickle-cell anemia screening
Effects to pregnancy and baby Pregnancy
Preterm or LBW
Blood transfusion
PPT depression
Anemic baby
Baby
Preterm or LBW
Neural tube defects
Possible complications
Nx Dx Imbalanced nutrition, less than body requirement r/t
increased physiologic needs
Deficient knowledge r/t need for increased intake of
nutrients especially iron during pregnancy
Nx mgmt Educate patient about proper diet consisting of green
leafy vegetables, meat and legumes
Refer to hematologist
Medical mgmt Prophylactic therapy (27 mg iron)
Sources:
(DynaMed, 2018)
(DynaMed, 2018)
(WebMD, 2018)