Maternal Risk Factors
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Factors That Can Put a Pregnancy at Risk (Mnemonic)
Fetal Alcohol Syndrome (Image)
Features of Fetal Alcohol Syndrome (Image)
Maternal Risk Factors (Cheatsheet)
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Outline
Overview
- Pre existing conditions put the mother at greater risk for complications
Nursing Points
General
- Genetic issues
- Risk of heredity
- Abuse and violence
- Nicotine or substance abuse
- Cross the placenta
- NO safe amount of alcohol
- Risk of fetal alcohol Syndrome (refer to FAS lessson)
- Sexually transmitted infection
- Can be passed to infant
- Herpes, Syphilis, HIV, AIDS, Hepatitis B
- Mental illness
- Postpartum Depression
- Postpartum Psychosis
- Cardiac conditions
- The heart is a pump
- Increased blood volume to be pumped during pregnancy
- Increased weight during pregnancy is more work on the heart
- Diabetes
- High blood sugars = increased insulin→ growth hormone = bigger baby
- Hormones in pregnancy raise blood sugar
- Underweight
- Poor nutrition to grow fetus
- Obesity
- At increased risk for diabetes and other concerns
- Gain more weight in pregnancy
- Poor nutrition → not good for fetal development
- Grow a larger fetus
- Hypertension
- High blood pressure→ grows a smaller fetus → doesn’t get proper nutrients
- Thyroid
- Increased risk of miscarriage and stillbirth
- Young (under 20)
- Lack of maturity for situation and understanding
- Poor nutrition
- More at risk for preeclampsia
- Advanced maternal age
- Older eggs
- Body doesn’t provide for the fetus as well as younger age
- Poverty
- Lack resources such as transportation to get to prenatal appointments
- Scant prenatal care
- No insurance
- Healthy food is more expensive
- Lack resources such as transportation to get to prenatal appointments
Assessment
- Assess their history
- HTN, Diabetes
- Assess weight
- Assess blood pressure
- Assess level of knowledge and importance of getting to appointments as well as ability.
Therapeutic Management
- Management of current risk factors/diseases
- Might need referral to specialist
- Diabetes educator and physician
- cardiologist
- Might need referral to high risk maternal/fetal doctor
- Make sure patient is taking prenatal vitamin
Nursing Concepts
- Reproduction
- Human Development
- Health Promotion
Patient Education
- Education on how to manage disease during pregnancy
- ie: more insulin requirements, cardiac medications, frequent blood pressure checks
- Education on the important of prenatal appointments
- Educate on prenatal vitamins
- Educate on the importance of avoiding substances and alcohol
- Smoking cessation
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Transcript
In this lesson I will better explain risk factors that could put a patient at greater risk for other comorbidities or her baby at risk during pregnancy.
Good health prior to pregnancy is essential. Promoting good health prior to pregnancy can better the outcomes for the mom and baby. Almost any health concern or disease process can put the mother and fetus at a greater risk such as; diabetes, hypertension, obesity, advanced maternal age, and cardiac conditions
Let’s look as specific risk factors and the why behind them. Genetics is a risk factor because if the mother has a genetic disorder it could make the pregnancy more difficult or theres a chance of her passing on the gene. Abuse and violence could worsen with a pregnancy, especially if it is an unwanted pregnancy. This puts the mother at a greater risk and of course the unborn child at risk. Nicotine and substance abuse means that the mother is already not in the healthiest state and the pregnancy could be difficult for her. The baby is also put at risk because they are at risk for deformities and being born addicted. Substances pass the placenta. With alcohol there is no safe amount during pregnancy and the fetus is at risk for fetal alcohol syndrome. (refer to fetal alcohol syndrome lesson for more information). Sexually transmitted infections can be passed to the infant. Mental illness can worsen during and after pregnancy because of hormone fluctuations.
Cardiac is a huge risk factor because during pregnancy the women have extra blood volume and the heart has to work harder. The heart is a pump so if the pump already has trouble then pregnancy is going to be hard on the pump. In pregnancy the hormones cause blood sugars to really increase so this can make diabetes hard to control. This puts the mom and fetus at risk. If a patient is too underweight or obese pregnancy will be difficult on them because they do not have good nutrition to be healthy and grow a healthy baby. Thyroid disorders cause a lot of miscarriage and stillbirth if not in control so this is a risk factor. Patients that are young (under 20) or advanced maternal age (over 35) are at a greater risk. The young are at risk for blood pressure concerns in pregnancy, specifically preeclampsia. The older population have older eggs and puts them more at risk for having babies with genetic disorders. An older patient but not be in as good of health either which increases the risk. Poverty is a risk factor because these patients lack resources. The patient might not be able to afford prenatal vitamins, healthy foods, and lack resources to get to prenatal appointments.
The assessment pieces that we need to gather are her history. Does she have a cardiac history? Diabetes? Genetic concerns? We need to know her weight so we can help her identify how much weight will be a healthy weight for her to gain. A current blood pressure to ensure she is in a current healthy range, which will be monitored throughout pregnancy. We also need to assess her level of knowledge. Does she realize the importance of coming to prenatal appointments and the need to take prenatal vitamins? Does she know how often she should be planning to go to appointments?
Our management of this patient is going to number one manage the problem! We have to treat the risk factor. Patients that are diabetic or become diabetic or are instructed by a physician for other reasons need to manage blood sugars.We can set the patient up with referrals such as specialist. Maybe she needs a dietician, endocrinologist, or high risk OB. We need to ensure she is taking her prenatal vitamins, We need to discuss follow up appointments to ensure she comes back for appointments.
Education for this patient is going to revolve around how she can manage the problem. Educate on the importance of prenatal vitamins and follow up appointments. She needs to understand the importance of avoiding substance and alcohol abuse as well as smoking cessation.
Good health prior to pregnancy is essential. The patient must be healthy to have a healthy pregnancy. Whatever we can do to make sure she isin the best health before and during the pregnancy will mean better outcomes. .T We will either have a baby that is small or large because of these risk factors. Prenatal care is imperative to help the patient manage her risk factor as well as ensure the baby is growing adequately.
Reproduction, human development, and health promotion are our nursing concepts.
Make sure you check out the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing.
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Concepts Covered:
- Basics of Sociology
- Statistics
- Communication
- Fundamentals of Emergency Nursing
- Musculoskeletal Disorders
- Cardiac Disorders
- Emergency Care of the Cardiac Patient
- Medication Administration
- Gastrointestinal Disorders
- Pregnancy Risks
- Labor Complications
- Factors Influencing Community Health
- Respiratory Disorders
- Emergency Care of the Neurological Patient
- EENT Disorders
- Newborn Complications
- Documentation and Communication
- Preoperative Nursing
- Legal and Ethical Issues
- Adult
- Substance Abuse Disorders
- Hematologic Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Microbiology
- Disorders of Pancreas
- Oncology Disorders
- Anxiety Disorders
- Neurologic and Cognitive Disorders
- Personality Disorders
- Basics of NCLEX
- Studying
- Newborn Care
- Basics of Mathematics
- Note Taking
- Integumentary Disorders
- Emergency Care of the Trauma Patient
- Respiratory Emergencies
- Developmental Considerations
- Digestive System
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- Central Nervous System Disorders – Brain
- Postpartum Care
- Basic
- Infectious Respiratory Disorder
- Integumentary Disorders
- Eating Disorders
- Circulatory System
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- Test Taking Strategies
- Musculoskeletal Disorders
- EENT Disorders
- Postoperative Nursing
- Neurological Emergencies
- Cognitive Disorders
- Concepts of Population Health
- Community Health Overview
- Noninfectious Respiratory Disorder
- Delegation
- Depressive Disorders
- Terminology
- Postpartum Complications
- Vascular Disorders
- Nervous System
- Upper GI Disorders
- Renal and Urinary Disorders
- Developmental Theories
- Fetal Development
- Endocrine and Metabolic Disorders
- Prenatal Concepts
- Trauma-Stress Disorders
- Psychological Emergencies
- Adulthood Growth and Development
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Renal Disorders
- Hematologic Disorders
- Liver & Gallbladder Disorders
- Tissues and Glands
- Disorders of Thermoregulation
- Urinary Disorders
- Urinary System
- Shock
- Labor and Delivery
- Oncologic Disorders
- Emotions and Motivation
- Peripheral Nervous System Disorders
- Bipolar Disorders
- Infectious Disease Disorders
- Immunological Disorders
- Sexually Transmitted Infections
- Disorders of the Thyroid & Parathyroid Glands
- Male Reproductive Disorders
- Central Nervous System Disorders – Spinal Cord
- Female Reproductive Disorders
- Acute & Chronic Renal Disorders
- Prioritization
- Somatoform Disorders
- Pediatric
- Perioperative Nursing Roles
- Concepts of Pharmacology
- Psychotic Disorders
- Concepts of Mental Health
- Neurological Trauma
- Health & Stress
- Respiratory System
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Lab Panels – The Basics and What YOU Need to Know 2 – Live Tutoring Archive
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Legal & Ethical Issues in ER
Nursing Care and Pathophysiology of Osteoporosis
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
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Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Neural Tube Defect, Spina Bifida
Nursing Care Plan (NCP) for Neutropenia
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