DIABETES MELLITUS

DIABETES MELLITUS - endocrine disorder in which the body is unable to produce enough insulin to meet the needs of glucose metabolism

CONTRIBUTING FACTORS:

• family history of diabetes prior to diagnosis of gestational diabetes
• hypertension, obesity,and 35 years old and above of age
• previous history of hydramios or infant weight of above 9 lbs.
  
• infant with congenital anomalies
  

POSSIBLE EFFECT OF DIABETES TO PREGNANT WOMAN:

• infection may become severe
• increase risk of pregnancy
• big fetus will cause birth trauma- resulting hemorrhage
  

EFFECT TO FETUS:

• hyperglycemia

MANAGEMENT:

• maintain glucose level through use of diet, exercise and insulin
• dietary control- includes caloric and glucose level
  
• consistent exercise is encouraged unless signs of uteroplacental insufficiency occur
• insulin as ordered by the obstetrician
  

FIBROID TUMOR OR MYOMATA

MYOMATOUS OR FIBROID TUMORS OF THE UTERUS -

• are benign tumors arising from the muscle tissue of the uterus
• develop slowly between the ages of 25 and 40

SIGN AND SYMPTOMS:

• small tumor causes no symptoms
  
• most common symptom is excessive and prolonged menstruation
  
• symptoms due to pressure on surrounding organs-pain, backache, constipation and urinary symptom
• tumors may sometimes cause sterility
• after myomas grow- it is a palpable mass

Diagnostic Procedure: ultra sound



*********************************************************************************
Surgical Terms:

• myomectomy ( removal of tumor) if tumors are small only
  
• hysterectomy (removal of uterus) -if large tumors producing - pressure symptoms to the surrounding organ
• hysteromyomectomy (removal of uterus and the tumors)- if tumors producing excessive bleeding
  

SEXUAL HEALTH

SEXUAL HEALTH - World Health Organization defined as " the integration of the somatic, emotional, intellectual and social aspect of sexual being, in ways that are positively enriching and that enhance personality, communication and love". This definition recognizes the biologic, psychologic and socio-cultural dimentions of sexuality.

CHARACTERISTICS OF SEXUAL HEALTH:

• knowledge about sexuality and sexual behavior
• ability to express one's full sexual potential. excluding all forms of sexual coercion, exploitation and abuse
• ability to make autonomous decisions about one's sexual life within a context of personal and social ethics
• eperience of sexual pleasure as a source of physical, psychologic, cognitive and spiritual well being
• capability to express sexuality through communication, touch, emotional expression and love
• right to make free and responsible reproductive choices
• ability to access sexual health care for the prevention and treatment of all sexual concerns, problems and diorders
  

SYPHILIS

SYPHILIS- caused by Treponema Pallidum

PRIMARY STAGE- hard chancre (ulcerated sore with hard chancre)

SECONDARY STAGE- presence of rashes and seen over the palm of hands and soles of the feet

TERTIARY STAGE-



EFFECTS ON PREGNANCY: -disease can passed to the fetus


EFFECTS OF FETUS / NEWBORN:

• premature
• congenital syphilis
• may die soon

'

GONORRHEA

GONORRHEA - most common sexually transmitted disease caused by Bacterium Neisseria Gonorrheae

SIGNS AND SYMPTOMS:

• pain upon urination
• thick, greenish-yellow urethral discharge

EFFECTS ON THE FETUS / NEWBORN

• ophthalmic infection -may lead to blindness
• bacterial sepsis
• nasopharyngeal, vaginal, anal, ear and mouth infection

EFFECTS ON PREGNANCY:

• preterm delivery
• premature rupture of membranes
• intrauterine growth retardation
  

GENITAL HERPES

GENITAL HERPES - caused by herpes simplex virus

TYPE 1- usually causing cold sores and fever blister

TYPE2-genital herpes are sexually acquired disease with signs and symptoms like:

• tingling and itchy sensation
• ruptured blister
• fever
• pain upon urination
• swollen lymph nodes

Cesarean Section is recommended to a pregnant woman-herpes simplex infected to prevent the newborn an occurrence of bacterial contact in the birth canal

UTERINE RUPTURE

UTERINE RUPTURE - spontaneous and traumatic rupture of the uterus

CAUSES:

• rupture of the scar of previous secarean section
• prolonged obstructed labor
• forced delivery of fetus with abnormalities like hydrocephalus
• application of forcep
• unwise use of oxytoxin
• excessive manual pressure applied to the fundus during delivery

SIGN AND SYMPTOMS OF COMPLETE RUPTURE

• sudden sharp abdominal pain during contraction
• abdominal tenderness
• cessation of contraction
• fetus easily palpated and no heart tone
• bleeding from abdominal cavity and fresh blood to the vagina
• signs of shock- rapid pulse, weak pulse, cold clammy skin

SIGNS AND SYMPTOMS OF INCOMPLETE RUPTURE:

• abdominal pain during contraction
• contraction continue but cervix fails to dilate
• vaginal bleeding may be present

MANAGEMENT:

• prepare for surgery
• blood transfusion to replace blood loss
• Antibiotics prevent infection of the ruptured uterus

my nursing notes
reference: maternal nursing book

RUPTURED OF THE UTERUS

UTERINE RUPTURE- abrupt rupture of the uterus

CAUSES:

• rupture of previous cesarean incesion site
• prolonged or obstructed labor
• forced delivery for fetus like polyhydramios
• forcep delivery- forcep instrument may sometimes hit the uterus
• excessive manual pressure applied to the fundus during delivery
  

AMNIOTIC FLUID EMBOLISM

AMNIOTIC FLUID EMBOLISM- is the escape of of amniotic fluid containing debris such as meconeum,lanugo and vernix caseosa into the maternal circulation resulting debris enters to pulmonary arterioles

CONDITIONS WHICH MAY CAUSE AMNIOTIC FLUID EMBOLISM

• uterine rupture
  
• hysterectomy
• marginal placental separation
  

Signs and Symptoms:

• dyspnea - difficulty of breathing
• chest pain
• cyanosis
• tachycardia
• shock due
  

Nursing Measures:

• close observation
  
• monitor vital signs and blood pressure
• blood transfusion as ordered by the doctor
  
• oxygination as ordered by the doctor

maternal nursing book and my nursing notes

PROLAPSED UMBILICAL CORD

PROLAPSED UMBILICAL CORD- cord prolapsed or appear infront or the cord on the presenting part

Signs:

• cord can be seen from the vagina
• cord could be palpated from the cervix or at the vaginal canal
• fetal heart beat decelarate between contraction
• possible fetal distress due to compression of the cord

PREDISPOSING CAUSES:

• hydramios
• prematurity
• umbilical or foot presentation
• ruptured membranes

MANAGEMENT:

• delivery as soon as possible
  

INVERTED UTERUS

INVERTED UTERUS- the uterus turns inside out during the third stage of labor

CAUSES:

• thin uterine wall
• excessive traction on the cord while placenta still attached to the uterine wall
• fundal pressure
• relaxed uterine wall

Signs and Symptoms:

• profuse bleeding
• shock due to blood loss
• pale
  
• weak

Management :

• to return the uterus to normal position
• Blood transfusion to replace the blood loss

Nursing Measures:

• monitor vital signs and blood pressure and record. Record intake and output
• regulate blood transfusion correctly and note any reactions
• observed any signs of bleeding