Week 4 DB response 2
Table 1 1-hour Oral Glucose Tolerance Test (OGTT) After a 50-g oral glucose load in pregnant women Table 2 Criteria for Abnormal Result on 100-g, 3-Hour Oral Glucose Tolerance Test in Pregnant Women Table 3 Define and differentiate between the following Postpartum Disorders: Normal Range (Negative) Abnormal Range (Positive) 1 hour < 140 mg/dL 130 – 140 mg/dL Blood Sample National Diabetes Data Group Criteria Carpenter and Coustan Criteria Fasting 105 mg/dL 95 mg/dL 1 hour 190 mg/dL 180 mg/dL 2 hours 165 mg/dL 155 mg/dL 3 hours 145 mg/dL 140 mg/dL What defines a positive 3-hour glucose tolerance test result (failed result)? Two or more threshold glucose levels on the 3-hour test must be met or exceeded. Definition Signs and Symptoms Management of the Diagnosis Postpartum Blues Short-lived mood change Sadness, weepiness, mood swings, irritability that occurs in the first few days to 10 days postpartum; lasts less than two weeks Family support, uninterrupted rest, exercise, adequate fluids, nutritious meals Table 4 Postpartum Depression Depression occurring within the first year postpartum that meets standard diagnostic criteria; lasts longer than two years Crying, feeling sad, overwhelmed, lack of interest in daily activities, lack of interest in infant, feeling sub- inadequacy Home support, therapy Postpartum Obsessive- Compulsive Disorder Need to perform repetitive physical or mental actions Onslaught of intrusive thoughts or rituals SSRIs and CBT Postpartum Psychosis Psychotic episode (delusions or break with reality) occurring within the first year after birth Auditory and visual hallucinations, various unexplained behaviors, i.e. smelling smoke Immediate care i.e. emergency room Definition Presentation (include Signs and Symptoms) Management of the Diagnosis Puerperal Fever Temp. 100.4 F or greater during postpartum period caused by bacterial infection in the reproductive tract or breasts Genital tract or wound infections breast engorgement, dehydration, DVT CBC w/ diff, urine analysis, cultures, radiology and/or ultrasound. Antimicrobial therapy Postpartum Hematoma Collection of blood in the vaginal, perineal, pelvic, or abdominal tissue, post childbirth Evidence of blood loss: Decrease hematocrit Severe perineal and/or rectal pain Management varies on size. Small hematomas can reabsorb; moderate to large hematomas may need I&D Secondary (delayed) Postpartum Hemorrhage Excessive bleeding that occurs between 24 hours after birth until six weeks postpartum Hemorrhage bleeding Masses suspicious for retained placental fragments Uterotonic agents: ergonovine, methylergonovine, oxytocin, a prostaglandin analog, or tranexamic acid. Surgical referral for suction evacuation to stop bleeding Sore Nipples The most common reasons for abandoning exclusive breastfeeding. Sore, painful, cracked. infection: exudate, increased erythema, pus, or dry scab Warm compresses, green tea bag compresses, coconut oil, hydrogel dressing, nipple shields, wash nipples with soap & water once daily, topical mupirocin, peppermint oil, topical low dose steroids for inflammation; antibiotic: Miconazole for C. albicans Jennifer is a G2P1, 31-year-old pregnant female at 24 weeks EGA who has come to the clinic for her 24-week prenatal visit and recommended screening tests. Jennifer’s one hour glucose test result is 156 mg/DL. Her BP is 118/78 T Read More …