Complications of Pregnancy: Endocrine Disorders Practice Flashcards

Exactly 210 vocabulary flashcards covering the concepts, risk factors, clinical findings, and nursing care for endocrine disorders during pregnancy based on the provided lecture notes.

Type 1 DM (Pregestational)

An autoimmune disorder characterized by decreased or absent insulin.

Type 2 DM (Pregestational)

Condition characterized by insulin resistance.

Human placental lactogen (hPL)

A pregnancy hormone associated with insulin resistance and placental development.

Type 1 Diabetes Mellitus Etiology

Results from both genetic and environmental factors.

Type 2 Diabetes Mellitus Etiology

Results from both genetic and lifestyle factors.

U.S. Prevalence of Type 1 DM

Approximately $1.7\,million$ adults.

Global Population Impact of Type 1 DM

$5.7\%$ of the world’s population.

Asian Population and Type 1 DM

The population with the lowest reported prevalence of Type 1 DM.

Peak Diagnosis Period for Type 1 DM

Diagnosis typically occurs in early adolescents.

Percentage of Pregnancies with Type 1 DM

$0.3\%$ of pregnancies.

Maternal and Fetal Risk in Type 1 DM

Associated with the highest risk for maternal and fetal morbidity and mortality.

Percentage of Pregnancies with Type 2 DM

Affects $1\%$ to $2\%$ of all pregnancies, with increasing numbers.

Psychosocial Impact of DM in Pregnancy

May include anxiety or depression due to increased surveillance and stress.

Fetal Complication: Congenital Malformations

Structural defects present at birth resulting from maternal endocrine disorders.

Preterm Birth

A consideration for diabetic pregnancies occurring before the completion of the gestational period.

Large for Gestational Age (LGA)

A fetal measurement outcome common in diabetic pregnancies.

Neonatal Hypoglycemia

A metabolic complication in newborns born to diabetic parents.

Neonatal Obesity

A potential long-term health complication for children after a diabetic pregnancy.

Diabetes Clinical Presentation: Polyphagia

Increased or excessive hunger.

Diabetes Clinical Presentation: Polydipsia

Increased or excessive thirst.

Diabetes Clinical Presentation: Polyuria

Increased or excessive urination.

Diabetes Clinical Presentation: Slow Wound Healing

A metabolic effect of diabetes leading to delayed tissue repair.

Hemoglobin A1C Goal in Pregnancy

Less than $6\%$ with testing performed every $2\,months$.

Fasting Blood Glucose Goal (ACOG, 2018c)

Less than $95\,mg/dL$.

1-hour Postprandial Glucose Goal (ACOG, 2018c)

Less than $140\,mg/dL$.

2-hour Postprandial Glucose Goal (ACOG, 2018c)

Less than $120\,mg/dL$.

First Trimester Insulin Adjustment (Type 1 DM)

The insulin dose is typically decreased.

Second and Third Trimester Insulin Adjustment (Type 1 DM)

The insulin dose is typically increased.

Rapid-acting Insulin

A medication that may be added to a Type 1 DM regimen during pregnancy.

Glyburide

An oral hypoglycemic medication used in the treatment of Type 2 DM during pregnancy.

Diabetic Educator/Nutritionist

Part of the interprofessional care team for clients with diabetes.

Perinatologist

A high-risk pregnancy specialist involved in diabetic care.

Endocrinologist

A physician specializing in hormone disorders involved in diabetic care.

Recognize Cues: Diabetes

The first step of the nursing process involving assessment.

Analyze Cues: Diabetes

The second step of the nursing process involving analysis.

Prioritize Hypothesis: Diabetes

The third step of the nursing process involving analysis of priorities.

Generate Solutions: Diabetes

The fourth step of the nursing process involving planning.

Take Action: Diabetes

The fifth step of the nursing process involving implementation.

Evaluate Outcomes: Diabetes

The sixth step of the nursing process involving evaluation.

Gestational Diabetes Mellitus (GDM) Timing

Increased insulin resistance usually appearing in the $2nd$ or $3rd$ trimester.

GDM Future Risk

Clients are more likely to develop Type 2 DM later in life.

Beta Cell Dysfunction

An etiological factor in the development of Gestational Diabetes Mellitus.

GDM Risk Factor: Body Mass Index (BMI)

$BMI > 25$.

GDM Risk Factor: History of A1C

A prior history of Hemoglobin A1C between $5.7\%$ and $6.4\%$.

History of LGA Infant (Kilograms)

A risk factor defined by a previous infant weighing above $4.08\,kilograms$.

History of LGA Infant (Pounds)

A risk factor defined by a previous infant weighing above $9\,pounds$.

Psychosocial Impact of GDM

Feelings of guilt, shame, anxiety, and depression.

1-hour Glucose Tolerance Test (GTT) Requirement

Performed on all clients with no fasting required.

1-hour GTT Threshold

A result greater than $140\,mg/dL$ requires further 3-hour screening.

3-hour GTT Diagnosis Criteria

Diagnosis confirmed if $2$ of the $4$ glucose levels are out of range.

3-hour GTT: Fasting Glucose Value

Desired level is less than $95\,mg/dL$.

3-hour GTT: 1-hour Postprandial Value

Desired level is less than $180\,mg/dL$.

3-hour GTT: 2-hour Postprandial Value

Desired level is less than $155\,mg/dL$.

3-hour GTT: 3-hour Postprandial Value

Desired level is less than $140\,mg/dL$.

GDM Nutritional Counseling: Carbohydrates

Recommended percentage is $40\%$.

GDM Nutritional Counseling: Protein

Recommended percentage is $20\%$.

GDM Nutritional Counseling: Fat

Recommended percentage is $40\%$.

GDM Dietary Inclusion

Emphasis on fiber and maintaining a food diary.

Recognize Cues: Gestational Diabetes

Assessment step of the nursing process for GDM.

Analyze Cues: Gestational Diabetes

Analysis step of the nursing process for GDM.

Prioritize Hypothesis: Gestational Diabetes

Prioritization step of the nursing process for GDM.

Generate Solutions: Gestational Diabetes

Planning step of the nursing process for GDM.

Take Action: Gestational Diabetes

Implementation step of the nursing process for GDM.

Evaluate Outcomes: Gestational Diabetes

Evaluation step of the nursing process for GDM.

Hyperemesis Gravidarum (HG) Hormonal Pathophysiology

Involves changes in hCG and progesterone.

Helicobacter pylori (H. pylori)

A bacteria associated with the pathophysiology of Hyperemesis Gravidarum.

Ptyalism

Excessive salivation sometimes associated with Hyperemesis Gravidarum.

HG Etiology: Molar Pregnancy

Raised hCG levels in molar pregnancy can lead to elevated estradiol and HG.

HG Epidemiology Percentage

Up to $3\%$ of clients are affected by Hyperemesis Gravidarum.

Nulliparous Client

A risk factor for Hyperemesis Gravidarum referring to a person who has never given birth.

HG Psychosocial Impact: PTSD

Post-Traumatic Stress Disorder resulting from severe pregnancy complications.

Clinical Sign of Dehydration: Urine Color

Dark or strong-smelling urine.

Clinical Sign of Dehydration: Heart Rate

Rapid heart rate (tachycardia).

HG Dehydration Signs: Physical

Dry mouth, lips, and eyes.

HG Lab Value: Potassium Range

Expected range of $3.5$ to $5\,mEq/L$.

HG Lab Value: Sodium Range

Expected range of $136$ to $145\,mEq/L$.

HG Lab Value: Calcium Range

Expected range of $9$ to $10.5\,mg/dL$.

HG Lab Value: Glucose Range

Expected range of $74$ to $106\,mg/dL$.

PUQE Score

Pregnancy Unique: Quantification of Emesis Score assessing the past $12\,hours$.

PUQE: 1 Point for Nausea Duration

$1\,hour$ or less.

PUQE: 4 Points for Nausea Duration

$4$ to $6\,hours$.

PUQE: 5 Points for Nausea Duration

Longer than $6\,hours$.

PUQE: 2 Points for Vomiting Episodes

$1$ to $2$ episodes.

PUQE: 5 Points for Vomiting Episodes

$7$ or more episodes.

PUQE: 3 Points for Dry Heave Episodes

$3$ to $4$ episodes.

HELP Score

Hyperemesis Level Prediction Score used for symptom severity assessment.

HELP Score: 0 Points for Nausea Level

Nausea level is $0$.

HELP Score: 5 Points for Urination Patterns

Rarely; dark or bloody urine with foul smell.

HELP Score: 3 Points for Vomiting Episodes

$6$ to $8$ episodes per day.

HELP Score: 1 Point for Weight Loss

$1\%$ weight loss over the last week.

Pharmacological HG Treatment: Vitamin B6

A supplement used for nausea control.

Pharmacological HG Treatment: Antihistamines

Medications used to help manage nausea in HG.

Non-pharmacological HG Treatment: Ginger

A natural remedy used to manage symptoms of nausea.

TPN (Total Parenteral Nutrition)

A treatment option for severe HG when oral intake is impossible.

Recognize Cues: Hyperemesis Gravidarum

Assessment step of the nursing process for HG.

Analyze Cues: Hyperemesis Gravidarum

Analysis step of the nursing process for HG.

Prioritize Hypothesis: Hyperemesis Gravidarum

Prioritization step of the nursing process for HG.

Generate Solutions: Hyperemesis Gravidarum

Planning step of the nursing process for HG.

Take Action: Hyperemesis Gravidarum

Implementation step of the nursing process for HG.

Evaluate Outcomes: Hyperemesis Gravidarum

Evaluation step of the nursing process for HG.