NCLEX-PN

L.​ Urinary tract infections (UTI) : The highest risk period for UTIs during pregnancy is from the 6th to the 24th week. Pregnant women face higher UTI risk due to normal anatomical changes like the enlarged uterus obstructing urine flow. ●​ Symptoms of UTIs, such as fever, dark or bloody urine, and pain, remain consistent during pregnancy. ●​ Complications include maternal hypertension, low birth weight, preterm labor, and potential renal damage. Levofloxacin, ampicillin, and ciprofloxacin are typical treatment choices, confirmed through urine culture and sensitivity. M.​ Pyelonephritis , likely due to E. coli, is a risk for pregnant women, especially those with diabetes, UTI, obstructions, bacteriuria, or chronic kidney disease. ●​ While some with acute or chronic pyelonephritis may be asymptomatic, most exhibit elevated blood urea nitrogen, malaise, painful urination, foul-smelling urine, hematuria, increased white blood cells, fever, and decreased creatinine clearance. N.​ Cardiac Disease : Similar to cardiac diseases that occur when not pregnant, cardiac diseases during pregnancy carry high morbidity and mortality rates. Pregnancy increases cardiovascular demands, affecting mothers with preexisting or pregnancy-induced cardiac disease. Aside from pre-existing and gestational hypertension, examples of cardiac disorders complicating pregnancy include: ○​ All preexisting congenital heart disorders ○​ Cardiomyopathy with left ventricular dysfunction ○​ Pulmonary hypertension due to left-to-right cardiac shunting (Eisenmenger syndrome) ○​ Rheumatic heart disease ○​ Marfan syndrome (genetic risk for aortic dissection/rupture) ○​ Mitral valve prolapse ●​ Pregnant clients exhibit varying symptoms based on the disorder's type and severity. Common signs include fatigue, shortness of breath, chest pain, palpitations, and abnormal breath sounds. ●​ Cardiac disease severity ranges from Class I (least severe) to Class IV (most severe). Class I/II allows activity without symptoms, while Class III/IV causes symptoms even with rest. Untreated Class III/IV can lead to maternal/fetal complications or death. O.​ Diabetes may preexist in pregnancy or develop during gestation. Regardless of type, diabetes adversely affects glucose regulation. Normal blood glucose levels during pregnancy are 70-110 mg/dL .

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