Heart Disease in Pregnancy

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  1. Class I
    • Uncompromised
    • No limitation of physical activity
    • symptomatic with ordinary activity
  2. Class II
    • Slight compromised
    • slight limitation of physical activity
    • comfortable at rest but ordinary physical activity causes fatigue: dyspnea, palpitations, or angina pain
  3. Interventions for Class I and Class II
    • 10 nhours of sleep at night
    • rest 1 hour after meals (on side)
    • rest throughout the day
    • stop anything that causes cardiac compromise
    • keep weight in normal range
    • prevent anemia (folic acid)
    • watch for infection
    • vaccinate
  4. Class III
    (high risk)
    • Markedly compromised
    • marked limitation of physical activity
    • comfortable at rest but less than ordinary physical activity causes: excessive fatigue, dyspnea, palpitations or angina pain
  5. Class IV
    (high risk)
    Inability to perform any physical activity without symptoms of cardiac insufficiency even at rest
  6. Interventions for Class III and Class IV
    • Bed rest most of the day
    • clot prevention
    • psychosocial issues (boredom)
    • Meds are individualized
    • no Coumadin-use heprin
    • digoxin is safe
    • no troubutaline
  7. Intrapartum NI
    • Prevent fluid overload
    • labor on side with head and shoulders elevated
    • keep discomfort to a minimum (epidural- watch for HTN)
    • vaginal delivery- forceps or vacuum to help with pushing
    • quiet and calm environment
    • may induce at 36 weeks
    • Minimize decompensation and decrease workload of the heart!
  8. Postpartum NI
    • Avoid abrupt position changes
    • monitor for fluid overload
    • monitor/prevent blood clots
    • monitor/prevent infection
    • monitor fetal heart rate
Card Set:
Heart Disease in Pregnancy
2015-04-03 02:05:34
heart disease pregnancy
heart disease in pregnancy
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