NUR 406 Exam 15

NUR 406 Exam 15
1. dynamics of high-risk pregnancy- closely interwoven relationships of four factors
Answer
physiology of pregnancy, pathology of the complication, psychology of pregnancy, psychology
of illness
2. in a normal women's pregnancy, increased insulin resistance beginsin 2nd half of pregnancy
Answer
the placenta produces increased amounts of human placental lactogen, estrogen, progesterone,
and other hormones
hormones cause increased resistance to insulin
maternal insulin demands rise as much as threefold (thought to be related to a combination of
hormonal antagonism to insulin and placental degradation of insulin)
3. in a diabetic pregnant woman
Answer
unable to increase production of insulin, pan- creas unable to produce sufficient insulin, insulin
not being used effectively
fails to meet the "diabetogenic" stress of the advancing pregnancy
especially complicating in the late 2nd and 3rd trimesters when insulin demands increase
4. without adequate insulin
Answer
glucose circulatesin the blood stream, unable to enter the cells
the energy-starved cells catabolize fats and proteinsfor energy causing;ketosisfrom fat wasting,
negative nitrogen balance from protein breakdown and muscle tissue wasting
5. 1 hr GTT
Answer
done between 24-28 weeks, oral glucose test, in the office, anytime of day, nonfasting, 50g
6. 3 hr GCT
Answer
done if is 1 hr GTT was abnormal, do after 3 days of 150g CHO and overnight fast
130-140 mg/dl
screen late 1st trimester if hx of insulin resistance, age >40, prior stillbirth, miscar- riage or
macrosomic or malformed infant
instruct pt to eat high CHO diet for three days and then fast overnight

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