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.
Study Guide pre LPN-RN
Concepts Covered:
- Cardiac Disorders
- Cardiovascular
- Emergency Care of the Cardiac Patient
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Central Nervous System Disorders – Brain
- Neurological
- Noninfectious Respiratory Disorder
- Respiratory
- Hematologic Disorders
- Delegation
- Perioperative Nursing Roles
- Acute & Chronic Renal Disorders
- Respiratory Emergencies
- Disorders of the Adrenal Gland
- Documentation and Communication
- Preoperative Nursing
- Legal and Ethical Issues
- Immunological Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Medication Administration
- Vascular Disorders
- Renal Disorders
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Gastrointestinal Disorders
- Newborn Complications
- Peripheral Nervous System Disorders
- Studying
- Integumentary Disorders
- Communication
- Microbiology
- Emergency Care of the Trauma Patient
- Urinary Disorders
- Integumentary Disorders
- Musculoskeletal Disorders
- Circulatory System
- EENT Disorders
- Postoperative Nursing
- Neurological Emergencies
- Disorders of Thermoregulation
- Neurological Trauma
- Basics of NCLEX
- Fundamentals of Emergency Nursing
- Integumentary Important Points
- Multisystem
- Test Taking Strategies
- Tissues and Glands
- Urinary System
- Emergency Care of the Neurological Patient
- Neurologic and Cognitive Disorders
- Central Nervous System Disorders – Spinal Cord
- Renal and Urinary Disorders
- Nervous System
- Respiratory Disorders
- Respiratory System
- Infectious Disease Disorders
- EENT Disorders
- Emergency Care of the Respiratory Patient
- Health & Stress
- Skeletal System
- Endocrine System
- Hematologic System
- Digestive System
- Reproductive System
- Endocrine and Metabolic Disorders
- Muscular System
- Sensory System
- Basics of Human Biology
- Adult
- Anxiety Disorders
- Depressive Disorders
- Dosage Calculations
- Understanding Society
- Concepts of Pharmacology
- Newborn Care
- Adulthood Growth and Development
- Pregnancy Risks
- Postpartum Complications
- Substance Abuse Disorders
- Bipolar Disorders
- Learning Pharmacology
- Psychotic Disorders
- Prenatal Concepts
- Prefixes
- Suffixes
- Fetal Development
- Terminology
- Proteins
- Statistics
- Med Term Basic
- Med Term Whole
- Labor Complications
- Labor and Delivery
- Postpartum Care
- Hematologic Disorders
- Cardiovascular Disorders
- Musculoskeletal Disorders
- Oncologic Disorders
- Eating Disorders
- Personality Disorders
- Trauma-Stress Disorders
- Developmental Considerations
- Concepts of Mental Health
- Psychological Emergencies
- Somatoform Disorders
- Prioritization
- Factors Influencing Community Health
- Community Health Overview