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Preexisting or Newly Acquired Illness

This document discusses nursing care for families experiencing pregnancy complications from preexisting or newly acquired illnesses. It focuses on caring for high-risk pregnancies related to cardiovascular and endocrine systems. The nursing process is applied, including assessment, nursing diagnoses, planning and implementing interventions, and evaluating outcomes. Specific conditions addressed include diabetes, heart disease, and renal/urinary issues. Guidelines are provided for managing these complications through the antepartum, intrapartum, and postpartum periods with a focus on education, monitoring, treatment, and reducing risks.

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117 views26 pages

Preexisting or Newly Acquired Illness

This document discusses nursing care for families experiencing pregnancy complications from preexisting or newly acquired illnesses. It focuses on caring for high-risk pregnancies related to cardiovascular and endocrine systems. The nursing process is applied, including assessment, nursing diagnoses, planning and implementing interventions, and evaluating outcomes. Specific conditions addressed include diabetes, heart disease, and renal/urinary issues. Guidelines are provided for managing these complications through the antepartum, intrapartum, and postpartum periods with a focus on education, monitoring, treatment, and reducing risks.

Uploaded by

Creciabullecer
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Nursing Care of a Family Experiencing a Pregnancy

Complication From a Preexisting or Newly Acquired Illness


Jethro Noel Chu Daños, RN, MAN
LEARNING OUTCOMES:
- To provide essential knowledge in relation to giving of care of a
family experiencing a pregnancy complication.
- To determine preexisting from newly acquired illness during
pregnancy.
- To integrate nursing process in providing specific management
related to the topic this week.
DEFINITION OF
A HIGH-RISK PREGNANCY
A 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.
Nursing Process Related to Care of a
Woman With a High-Risk Pregnancy
• Assessment
❖ Objective data
❖ Subjective data
• Nursing diagnoses
• Outcome identification and planning
• Implementation
• Outcome evaluation
ESTABLISHING A
BASELINE WHEN
CARING FOR
A WOMAN WITH A
HIGH-RISK
PREGNANCY
2020 National Health Goals Related to Complications of Pregnancy
❖Reduce the rate of fetal deaths to 5.6 per 1,000 live births
from a baseline of 6.2 per 1,000 live births.
❖Reduce the rate of maternal deaths to 11.4 per 100,000 live
births from a baseline of 12.7 per 100,000 live births.
❖Reduce the rate of maternal illness and complications during
pregnancy to 28 per 100 births from a baseline of 31.1 per
100 births.
HIGH-RISK PREGNANCY: CARDIOVASCULAR SYSTEM
❖Cardiovascular disease complicates only 1% of pregnancies
but accounts for 5% of maternal deaths.
❖Blood volume and cardiac output increase up to 50%%
during pregnancy (peaks at 28 to 32 weeks), which places
stress on a compromised heart.
❖New York Heart Association criteria is commonly used to
categorize severity of heart disease.
HIGH-RISK PREGNANCY: COMMON CARDIOVASCULAR
CLINICAL FINDINGS
• Left-sided heart failure
❖ Orthopnea
❖ Paroxysmal nocturnal dyspnea
• Right-sided heart failure
❖ Distended liver and spleen
❖ Ascites
❖ Peripheral edema
HIGH-RISK PREGNANCY: CARDIOVASCULAR ISSUES
❖Valve damage with or without valve replacement
❖Congenital anomalies
❖Coronary artery disease (CAD)
❖Chronic hypertensive vascular disease
❖Venous thromboembolic disease
❖Peripartum heart disease
HIGH-RISK PREGNANCY:
CARDIOVASCULAR SYSTEM ASSESSMENT
❖Level of exercise
❖Presence of cough or edema
❖Comparison of baseline vital signs
❖Liver size (right-sided heart failure involvement)
❖ECG/echocardiogram
❖Fetal size (small for gestational age) and poor response
to labor (FHR decelerations)
HIGH-RISK PREGNANCY: CARDIOVASCULAR SYSTEM
NURSING DIAGNOSIS (EXAMPLE)
Deficient knowledge regarding steps to take to reduce the
effects of maternal cardiovascular disease on the
pregnancy and fetus
HIGH-RISK PREGNANCY: CARDIOVASCULAR SYSTEM
NURSING INTERVENTIONS DURING ANTEPARTAL PERIOD
❖Promote rest.
❖Promote healthy nutrition.
❖Educate regarding medication.
❖Educate regarding avoidance of infection.
HIGH-RISK PREGNANCY: CARDIOVASCULAR SYSTEM
NURSING INTERVENTIONS DURING INTRAPARTUM AND
POSTPARTUM PERIODS
• Intrapartum period
❖ Positioning
❖ Epidural anesthesia and assisted vaginal delivery
• Postpartum period
❖ Assess for heart failure
❖ Anticoagulant and digoxin therapy
❖ Intermittent pneumatic compression boots
QUALITY & SAFETY EDUCATION FOR NURSES (QSEN)
❖Patient-Centered Care
❖Teamwork & Collaboration
❖Evidence-Based Practice
❖Quality Improvement
❖Safety
❖Informatics
Reducing Risk of
Thromboembolic Disease
Through QSEN
Competencies
HIGH-RISK PREGNANCY: ENDOCRINE SYSTEM #1
❖Diabetes mellitus
• Pathophysiology and clinical manifestations
• Classification
• Gestational diabetes
❖Diabetes during pregnancy
• Decreased control of glucose regulation
• Effect on fetal size, infant hypoglycemia, and increased incidence of
congenital anomalies
HIGH-RISK PREGNANCY: ENDOCRINE SYSTEM #2

❖Diabetes during pregnancy—(cont.)


• Screening during pregnancy
• Monitoring during pregnancy
HIGH-RISK PREGNANCY: ENDOCRINE SYSTEM #3
❖Diabetes during pregnancy—(cont.)
• Nursing diagnoses and related interventions
o Nursing diagnosis: “Deficient knowledge related to a therapeutic
regimen necessary during pregnancy”
o Interventions:
✓Education regarding nutrition during pregnancy
✓Education regarding exercise during pregnancy
HIGH-RISK PREGNANCY: ENDOCRINE SYSTEM #4
❖Diabetes during pregnancy—(cont.)
• Therapeutic management
o Insulin needs and dosage adjustments
• Education related to blood glucose monitoring
o Insulin pump therapy
• Education related to pump care and use
o Tests for placental function and fetal well-being
• Education related to recording fetal movement
o Postpartum management of blood glucose
HIGH-RISK PREGNANCY:
RENAL AND URINARY
SYSTEM ASSESSMENT
HIGH-RISK PREGNANCY: INTERVENTIONS
RELATED TO PREVENTION OF RENAL AND
URINARY TRACT DISORDERS 3
❖Nutritional consults and monitoring fluid intake
❖Hygiene
❖Voiding frequently and after sexual intercourse
❖Cranberry juice intake
CARING FOR WOMAN WITH MULTIPLE THREATS TO HER
PREGNANCY #1
CARING FOR
WOMAN WITH
MULTIPLE THREATS
TO HER PREGNANCY
#1 CONT.
CARING FOR
WOMAN
WITH
MULTIPLE
THREATS TO
HER
PREGNANCY
#2
END
THANK YOU
FOR LISTENING
☺

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