1.

4 Hematologic Disorder and pregnancy

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1. READ • Coagulation disorders or blood for-

mation makeup hematologic disorders
among pregnant women.

• Since childbirth involves the loss of a lot

of blood, hemorrhage would be very dan-
gerous to a woman with these disorders.

2. Iron-deficiency anemia is the most common anemia among

pregnant women, mainly because many
women enter pregnancy already deficient
in iron stores because of low intake of
iron.

3. 12mg/dl A hemoglobin level below

33% ______________________ with hemat-
ocrit below _________ is a possible sign
of iron deficiency

4. microcytic Iron-deficiency anemia is a

_________________, hypochromic ane-
mia because when inadequate iron is in-
gested, it would be unavailable for incor-
poration into red blood cells.

5. low birth weight and preterm Iron-deficiency anemia is mildly associat-

birth ed with _______________________ and
___________________.

6. Extreme fatigue Signs and symptoms (2)

poor exercise tolerance

7. take prenatal vitamins contain- Treatment (2)

ing an iron supplement of 60 mg
elemental iron.

eat a diet high in iron such

as green leafy vegetables, meat,
legumes, and fruit.

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8. 120 to 200 mg
constipation and gastric irrita-
tion
When a pregnant woman has developed
anemia during pregnancy, she will be
prescribed with ___________________
supplemental iron per day in the form of
ferrous sulfate or ferrous gluconate.

Iron is best absorbed in an acidic medi-

um, so advise the woman to take her
iron supplements with orange juice or a
vitamin c supplement. (iron + vitamin C)

Side effects of iron ther-

apy include ____________ and
_________________.

Ferrous sulfate turns stool black so cau-

tion women with this side effect.

9. Folic acid is vital for the normal formation of red

blood cells in the mother.

It also prevents neural tube defects in the

fetus.

10. Spina bifida(meningomyelocele) is the most common neural tube defect,

affecting approximately one out of every
1,000 newborns

11. Neural tube defects can affect bones of the spine, the spinal
cord or the nerve roots that extend from
the spine into the body.

12. neural tube Normally, during your first month of preg-

nancy, the two sides of the fetus's spine
(backbone) join together to cover and
protect the spinal cord, spinal nerves
and meninges (the tissues covering the
spinal cord). At this point, the devel-
oping brain and spine are called the
_______________________.
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As development progresses, the top of

the neural tube becomes the brain, and
the rest of the tube becomes the spinal
cord.

An NTD happens when this tube doesn't

close completely somewhere along its
length.

13. Neurodevelopmental treatment NTD

(NDT)

14. Folic acid anemia is a megaloblastic anemia wherein the

(MCV)mean corpuscular volume is ele-
vated.

15. early miscarriage or premature COMPLICATIONS

separation
This anemia is most apparent during
the second trimester of pregnancy and
may contribute to________________ or
_____________ of the placenta.

16. 400 µg of folic acid daily MANAGEMENT AND NURSING CON-

folacin rich foods (VIT. B9) SIDERATIONS

Women who are expecting to

be pregnant are advised to take
____________________________.

Advise the woman to take

_____________________ such as green
leafy vegetables, oranges, and dried
beans.

17. Sickle cell anemia It is an inherited disease where the nor-

mal RBC is sickle in shape.

18. Why are they sickle in shape?

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It is because HgbS (abnormal
form of hemoglobin protein),
is produced instead of normal
HgbA. The sickle shape of the
cell decreases the ability of the
RBCs to carry oxygen and move
through the capillary. They often
clump together forming clots.

19. Sickle cell anemia is a recessively inherited hemolytic ane-

mia caused by an abnormal amino acid
in the beta chain of hemoglobin.

20. bacteriuria A pregnant woman with sickle

cell anemia is more prone to
____________________, so a clean
catch urine sample is collected during
pregnancy to detect the disease while it
is asymptomatic.

21. Sickle cell anemia "inherited red blood cell disorder"

22. Infections Complications (5)

stroke
URIs
Leg ulcers
Splenomegaly

23. upper respiratory infection (URI) URI

24. Hydration TREATMENT (HOP)

Oxygenation
Pain relief

25. Advise the woman to elevate her NURSING MANAGEMENT

legs while sitting or lie on her left
side while sleeping to encourage
venous return from the lower ex-
tremities.

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Instruct the woman to avoid
standing for long periods during
the day. Fetal health is moni-
tored through ultrasound at 16 to
24 weeks to assess for intrauter-
ine growth restriction.

The woman's diet must contain

sufficient amounts of folic acid
to help in building new red blood
cells.

26. dehydration Fluid intake should also be emphasized

because ________________ can lead to
a sickle cell crisis.

27. Folic Acid good for the brain development of the

baby

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