Cardiac (Heart) Disease in Pregnancy
Included In This Lesson
Study Tools For Cardiac (Heart) Disease in Pregnancy
Outline
Overview
- Pregnant patients with underlying cardiac disease may not be able to compensate appropriately for the increased blood volume / cardiac output
Nursing Points
General
- Concerning cardiac issues include, but are not limited to:
- Heart valve replacements (tissue and mechanical
- Marfan syndrome
- Cardiomyopathy
- Pulmonary HTN
- Congenital heart issue
- Heart failure
Assessment
- Baseline assessment of hemodynamics of both mom and fetus important
- Auscultate and note abnormal heart/lung sounds
- Murmurs are normal in pregnancy because of the extra blood volume
- Note any pain, discomfort with normal activity
- Cardiac monitoring may be indicated during labor
Therapeutic Management
- Manage as usual for the specific cardiac disease
- Administer diuretics to decrease preload if needed
Nursing Concepts
- Perfusion
- Fluid & Electrolytes
Patient Education
- Educate on appropriate weight gain
- Baseline obesity will place the client at even greater risk
- Healthy diet, low sodium
ADPIE Related Lessons
Related Nursing Process (ADPIE) Lessons for Cardiac (Heart) Disease in Pregnancy
Transcript
In this lesson I will explain cardiac disease in a pregnancy and your role in caring for this type of patient.
Let’s look at cardiac disease and why it is a problem in pregnancy. Pregnancy puts an increased workload on the heart because there is extra volume and then there is also increased weight that increases the work on the heart so this is even more of a problem for a patient that already has a not so good heart. Now let’s look at the heart. The heart is a pump and it is not able to pump effectively if there is cardiac disease. So the pump will be working harder in pregnancy to move the extra volume and get healthy blood flow through the placenta and to the fetus.
Some concerning cardiac issues can include heart valve replacements, marfan syndrome, cardiomyopathy, pulmonary HTN, congenital heart issue, and heart failure. Of course these are not all of them but a few examples that could lead to extra workload on the heart. Even women with no cardiac diseases can develop a problem in pregnancy because the heart can’t keep up with the extra weight and or volume.
For assessment we always need a baseline. So a baseline assessment of hemodynamics for mom and fetus is important. We need to auscultate heart and lung sounds. If there is any abnormality it needs to be noted. It is important to be aware that murmurs can be a normal finding in pregnancy because of the extra blood volume. If there is any pain or discomfort with normal activity it needs to be noted and reported.
For management we need to treat the disease, Whatever cardiac disease it is we need to manage with whatever is specific for the disease. If fluid overload is a piece of the problem we can give diuretics to decrease the preload. In this picture you can see how if there is an increase in preload, the blood coming into the heart, it is going to add increased work on the heart and if the heart is already diseased it will be even harder for the “pump” to pump.
Perfusion, oxygenation and fluid & electrolytes are the concepts. We need good perfusion to get to the blood and oxygen to the tissues and fetus. Fluid and electrolytes are important to manage and balance with cardiac disease.
For education we need to educate on appropriate weight gain. We do not want a cardiac patient to gain too much weight because this will add extra work to heart. If a patient is already overweight or obese this will put the patient at an even greater risk. A healthy diet should be instructed so the patient stays at a healthy weight and a diet low in sodium is important. Patients should also know signs to report such as a sudden increase in edema, shortness of breath, decreased fetal movement, and extreme tiredness.
Our key points to bring it all together are that in pregnancy there is an increased workload on the heart so the pump can get tired. The pump is also broken, it is not working at 100%. Pregnancy makes it even harder to manage the disease because of the pump being tired. Perfusion is the last key point. Not only do we need to perfuse the body as usual but also a placenta to get nutrients to the fetus. This is essential for healthy growth of the fetus. If our pump isn’t effective the perfusion to the body and placenta won’t be effective.
Make sure you check out the resources attached to this lesson and review different management of the various cardiac diseases. Now, go out and be your best selves today. And, as always, happy nursing.
Tiona RN
Concepts Covered:
- Studying
- Medication Administration
- Adult
- Emergency Care of the Cardiac Patient
- Intraoperative Nursing
- Microbiology
- Cardiac Disorders
- Vascular Disorders
- Nervous System
- Upper GI Disorders
- Central Nervous System Disorders – Brain
- Immunological Disorders
- Fundamentals of Emergency Nursing
- Dosage Calculations
- Understanding Society
- Circulatory System
- Concepts of Pharmacology
- Hematologic Disorders
- Newborn Care
- Adulthood Growth and Development
- Disorders of Pancreas
- Postoperative Nursing
- Pregnancy Risks
- Neurological
- Postpartum Complications
- Noninfectious Respiratory Disorder
- Peripheral Nervous System Disorders
- Learning Pharmacology
- Prenatal Concepts
- Tissues and Glands
- Developmental Considerations
- Factors Influencing Community Health
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Developmental Theories
- Basic
- Neonatal
- Pediatric
- Gastrointestinal
- Newborn Complications
- Labor Complications
- Fetal Development
- Terminology
- Labor and Delivery
- Postpartum Care
- Communication
- Basics of Mathematics
- Statistics
- Basics of Sociology
- Cardiovascular
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of the Thyroid & Parathyroid Glands
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Respiratory
- Delegation
- Perioperative Nursing Roles
- Acute & Chronic Renal Disorders
- Respiratory Emergencies
- Disorders of the Adrenal Gland
- Documentation and Communication
- Preoperative Nursing
- Legal and Ethical Issues
- Oncology Disorders
- Female Reproductive Disorders
- Musculoskeletal Trauma
- Renal Disorders
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Integumentary Disorders
- Emergency Care of the Trauma Patient
- Urinary Disorders
- Musculoskeletal Disorders
- EENT Disorders
- Neurological Emergencies
- Disorders of Thermoregulation
- Neurological Trauma
- Basics of NCLEX
- Integumentary Important Points
- Multisystem
- Test Taking Strategies
- Urinary System
- Emergency Care of the Neurological Patient
- Central Nervous System Disorders – Spinal Cord
- Respiratory System
- Emergency Care of the Respiratory Patient
- Cognitive Disorders
- Anxiety Disorders
- Depressive Disorders
- Trauma-Stress Disorders
- Substance Abuse Disorders
- Bipolar Disorders
- Psychotic Disorders
- Concepts of Mental Health
- Eating Disorders
- Personality Disorders
- Health & Stress
- Psychological Emergencies
- Somatoform Disorders
- Prioritization
- Community Health Overview
- Gastrointestinal Disorders
- Integumentary Disorders
- Respiratory Disorders
- Neurologic and Cognitive Disorders
- Renal and Urinary Disorders
- Infectious Disease Disorders
- EENT Disorders
- Hematologic Disorders
- Cardiovascular Disorders
- Musculoskeletal Disorders
- Endocrine and Metabolic Disorders
- Oncologic Disorders
- Behavior
- Emotions and Motivation
- Growth & Development
- Intelligence and Language
- Psychological Disorders
- State of Consciousness
- Note Taking
- Concepts of Population Health
- Basics of Human Biology