Te Manaaki i ngā Whaea me ngā Mate Ngākau
He tukanga ā-tinana te hapūtanga e puta ai ngā huringa nui ki te tinana o te whaea. Ko te nuinga o ēnei huringa ka pā ki te pūnaha manawa: ka piki ake te nui o te toto, ka piki ake te tere o te ngakau, ā, ka piki ake te mahi a te ngakau. Mō ngā wāhine hapū he mate ngakau—nō te whānautanga mai, nō te whānau mai rānei—ka taea e ēnei huringa te whakaoho i te ngoikore o te tinana, te kino ake o ngā tohu, me te whakanui ake i te tūponotanga o ngā raruraru mō te whaea me te tamaiti i roto i te pēpi. Nō reira, me whai huarahi whānui, mahi tahi, me te haere tonu te tiaki i ngā wāhine he mate ngakau mai i mua i te hapūtanga tae noa ki te wā i muri i te whānautanga.
Te Mārama me ngā Momo o ngā Āhuatanga Hē o te Ngākau i te Wā Hapūtanga
Ko ngā mate ngakau o te whaea ka uru atu ki te mate ngakau whānau (hei tauira, te mate septal atrial/ventricular), te mate takirere (mitral/aortic stenosis, regurgitation rānei), te cardiomyopathy, te arrhythmias, me te mate ngakau nā te toto toto tiketike pūkahukahu, te mate uaua coronary rānei. I roto i te mahi, ko te wero nui ko te aromatawai i te pai o te urutau o te ngakau ki ngā tono o te haputanga. He maha ngā wā ka whakatauhia te kaha mā te whakarōpūtanga mahi (hei tauira, i runga i te manawanui ki te mahi), te aroaro o te toto toto tiketike pūkahukahu, te hītori o te ngoikore o te ngakau, me te mahi ventricular i runga i te echocardiography.
Te Pānga o te Hapūtanga ki te Pūnaha Ngākau
I te wā e hapu ana, ka piki ake te putanga o te ngakau mā te 30–50% pea, ka eke ki tōna taumata teitei i te rua ki te toru o ngā marama. Ka piki ake te rahinga o te toto toto, ka piki ake te mōrearea o te pupuhi me te poto o te manawa. I te wā e whānau ana, ka piki ake te whakamahinga o te hāora me te kawenga o te ngakau nā te whakaheke me te mamae o te kōpū. I muri i te whānautanga, ka puta te "whakawhitinga-ā-roto" mai i te kōpū ki te tohanga toto o te whaea, ka hua ake he pikinga ohorere o te kawenga o te ngakau mō ngā haora 24–72 i muri i te whānautanga. He wā tino nui tēnei wā i muri i te whānautanga mō ngā whaea he mate ngakau, nā te mea ka piki ake te mōrearea o te pupuhi pūkahukahu me te ngoikore o te ngakau.
Te Kaupapa o te Manaaki
Ko te whāinga o te tiaki i ngā whaea he mate ngākau ko:
1. Kia mau tonu te pumau o te toto o te whaea, me te ārai i te ngoikore o te ngakau.
2. Whakaitihia te mōrearea o ngā raruraru thromboembolic, te arrhythmia, te edema pūkahukahu, me te mate urutā.
3. Aroturuki i te tipu me te whanaketanga o te kukune, me te ārai i ngā mate urutā o te rere toto i roto i te kōpū.
4. Te whakamahere i tētahi whānautanga haumaru e tika ana mō ngā āhuatanga o te ngākau me te ngākau.
5. Whakaritea he tiaki haumaru mō muri i te whānautanga me te whāngai ū, tae atu ki ngā whakarerekētanga rongoā.
Te Tiaki i mua i te whānautanga (I te wā e hapu ana)
1. Aromatawai Tūponotanga me te Aromatawai
Kei roto i te aromatawai tuatahi he hītori o te mate manawa (momo, ngā pokanga o mua, ngā rongoā), he hītori o te poto o te manawa, te mamae o te uma, te ngoikore, te tere o te manawa, me ngā mahi katoa e whakaoho ana i ngā tohu. Ka aromatawaihia e te whakamātautau tinana ngā tohu o te ngoikore o te ngakau (tachycardia, dyspnea, rhonchi, edema, te pikinga o te pēhanga uaua jugular) me te mātotoru o te hāora. Kei roto i ngā whakamātautau tāpiri he ECG, he echocardiography, me ngā whakamātautau taiwhanga pēnei i te hemoglobin me ngā whakamātautau mahi tākihi, mēnā e tika ana. Kei roto hoki i te aromatawai mōrearea ngā āhuatanga whānau pēnei i te preeclampsia, te anemia, te mate pāwera rānei, ka taea te whakanui ake i te taumahatanga ki te ngakau.
2. Ngā Haerenga ANC Auau me te Mahi Tahi a te Rōpū
Ko ngā whaea he mate ngākau te tikanga me toro atu ki te whānautanga i ngā wā maha atu i te hunga kāore he mate tāpiri. Ko te huarahi pai ko te tauira rōpū: he tākuta whānau, he tākuta ngakau, he kaiwhakawhanau, he nēhi, he tākuta moepuku, ā, ki te tika, he tākuta tamariki/tākuta pēpi hou. He mea nui tēnei mahi tahi mō te whakawhanake i tētahi mahere whānau me te whakarite kia tukuna wawetia mēnā ka kino haere te āhua.
3. Te Mātauranga me te Whakarerekētanga o te Āhua Noho
E whakanui ana te mātauranga i te hiranga o te mōhio ki ngā tohu whakatūpato: te piki haere o te poto o te manawa, te uaua ki te moe nā te poto o te manawa (orthopnea), te maremare huka, te tere o te pao o te puku, te pupuhi tere, te hemo, te mamae rānei o te uma. E tohutohuhia ana ngā whaea kia whakahaere i ā rātou mahi me te okioki, kia moe i te āhua noho-haurua mēnā he ngāwari ki te poto te manawa, ā, kia karo i ngā mahi uaua e whakaoho ana i ngā tohu. Me whakarato i te kai totika, me te whakaiti i te tote mēnā he āhua pupuri wai. Me ārai me te rongoā i te anemia nā te mea ka piki ake te taumaha o te ngākau.
4. Te Whakaora me te Whakatutukitanga o ngā Rongoā
Ehara i te mea he haumaru ngā rongoā ngākau katoa i te wā e hapū ana. Nō reira, me haere tahi te piri ki ngā tikanga rongoā me ngā whakarerekētanga ki te tikanga e te tākuta. Hei tauira, he here kei ētahi rongoā whakaheke toto, rongoā ārai toto rānei i ētahi toru marama o te hapūtanga. Me whakamārama mārama ki ngā whaea te horopeta, te wātaka, ngā pānga taha, me te aukati i te whakamutu i te rongoā me te kore kōrero. Me aroturuki tonu te toto toto, te pākia o te manawa, te taumaha, me ngā tohu.
5. Te Aroturuki i te Pēpi
Ka taea e te mate manawa o te whaea te whakaiti i te rere o te toto ki roto i te whenua, ka tūpono te tamaiti ki te aukati i te tipu, te whānautanga wawe, te mamae rānei o te tamaiti. Ko te aroturukitanga mā te ine i te teitei o te puku, te ultrasound tipu, me te aromatawai i te oranga o te tamaiti (hei tauira, te nekehanga o te tamaiti i ia rā me ngā whakamātautau e tohuhia ana) he wāhanga nui o te tiaki.
Te Tiaki i roto i te Whānautanga (I te Wā Whānautanga)
1. Te Whakamahere Whānau
Ka taea e te nuinga o ngā wāhine he mate ngākau te whānau mā te tara mēnā he pumau tō rātou āhua, nā te mea he nui ake te mōrearea o te toto, te mate urutā, me ngā huringa nui o te toto i roto i ngā mahi whakawhānau. Heoi, me whakatau te huarahi whānau i runga i te āhua o te ngākau, te āhua o te whānautanga, me ngā taunakitanga a te tīma. Ko te mea pai ko te whānau i roto i tētahi whare hauora me ngā āheinga aroturuki me te tiaki ohorere.
2. Te Aroturuki me te Tūnga Pūmau
I te wā e whānau ana, me aro turuki tonu ngā tohu ora, te mātotoru o te hāora, me te taurite o te wai. Me takoto te whaea ki tōna taha maui hei whakapai ake i te hokinga mai o te uaua me te rere o te toto ki roto i te kōpū. Me ata whakahaere te tuku wai ki roto i te uaua kia kore ai e nui rawa te wai. Ka tukuna te hāora mēnā ka heke te mātotoru, ka ahua poto rānei te manawa o te whaea.
3. Te Whakahaere Mamae me te Whakaiti i te Taumahatanga o te Manawa
Ka piki ake te taumaha o te ngākau i te mamae me te manukanuka. Nō reira, mā te whakahaere tika i te mamae (i runga i te wātea o te rongoā whakamoe me ngā taunakitanga) ka āwhina i te whakaū i te rere o te toto. He maha ngā wā ka whakapotohia te wāhanga tuarua o te whānautanga (hei tauira, mā te āwhina taputapu) i ētahi āhuatanga hei whakaiti i te pēhi roa, ka taea ai te whakanui ake i te pēhanga o roto o te uma me te whakararu i te ngākau.
4. Te Ārai i ngā Whakararuraru
Kia tūpato ki ngā tohu o te ngoikore o te ngākau: te tere o te manawa, te makuku o te manawa, te heke o te mātotoru o te manawa, te kore e marino, te maremare, te cyanosis rānei. Me tere te maimoatanga, tae atu ki te mahi tahi a te rōpū, te tūnga o te pane ki runga, te hāora, me te rongoā e tika ana mō te kawa. Hei tāpiri, ka taea te whakanui ake i te mōrearea o te thromboembolism e ētahi āhuatanga (hei tauira, te atrial fibrillation, ngā takirere miihini, te aukati i te nekehanga), nō reira me whakarite ngā rautaki ārai mate ki ngā taunakitanga a te tākuta.
Te Tiaki i te Wā i Muri i te Whānautanga (Wā i Muri i te Whānautanga)
He maha ngā wā ka warewarehia te wā muri i te whānautanga, engari he wā tino nui. I muri i te whānautanga, ka taea e ngā panoni wai te whakaoho i te pupuhi pūkahukahu me te ngoikore o te ngākau, inā koa i ngā rā tuatahi e 2–3. Ko te tiaki i muri i te whānautanga ko te aroturuki tata i ngā tohu ora, te aromatawai i te poto o te manawa, te aromatawai i te pupuhi, me te tuhi i te kai me te putanga. Ka mahia te nekehanga wawe me te haumaru, i runga i te āhua o te whaea, hei ārai i te thrombosis, me te whakatairanga i te manawanui ki ngā mahi.
Ngā Whakarerekētanga mō te Whāngai U me te Rongoā
Ko te whāngai ū te mea e taunakihia ana i te nuinga o te wā, engari ka taea e ētahi rongoā ngākau te uru ki roto i te waiū ū. Nō reira, he mea nui kia arotakehia te haumaru o ngā rongoā i te wā e whāngai ana, ā, whakaarohia ngā huarahi kē atu mēnā e tika ana. Me tautoko hoki ngā whaea hei ārai i te ngenge; he mea nui te wā okiokinga tika, te tautoko whānau, me te whakahaere ahotea hei ārai i te hokinga mai o ngā tohu.
Te Tohutohu Whakamahere Whānau me te Whakamahere mō te Hapūtanga e Whai Ake Nei
He wāhanga matua o te tiaki te tohutohu whakamahere whānau. He nui te mōrearea o ētahi mate ngākau mō ngā hāputanga o muri mai, nō reira me haumaru ngā kōwhiringa ārai hapūtanga mō ngā mate ngākau me ngā taunekeneke rongoā (hei tauira, ngā rongoā ārai hapūtanga). Mena kei te whakamahere te wahine i tētahi hāputanga o muri mai, he mea tino taunaki kia aromatawaihia i mua i te haputanga e tētahi tīma.
Te Tūranga o ngā Kaiwhakawhanau me ngā Kaimahi Hauora
He mahi nui tā ngā kaiwhakawhanau me ngā nēhi hei hononga i waenga i te whaea, te whānau, me te tīma hauora. Kei roto i tēnei mahi ko te kite wawe i ngā tohu mōrearea, te mātauranga, te aroturuki i te piripono ki ngā rongoā, te tautoko hinengaro, me te whakarite kia tukuna wawetia ngā tohu. Ko ngā tuhinga tika—tae atu ki ngā tohu, ngā tohu ora, te urupare ki te rongoā, me ngā mahere whai muri—ka tautoko i te haumaru o te tūroro.
Whakamutunga
Ko te tiaki i ngā whaea he mate ngākau me whai huarahi whānui mai i te hapūtanga ki te whānautanga me te wā i muri i te whānautanga. Ko ngā kī ki te angitu ko te aromatawai tika i te mōrearea, te aroturuki tata, te mātauranga tika, te whakahaere i ngā mahi me te wai, me te mahi tahi a ngā momo marautanga. Mā te tiaki kua whakaritea me te haere tonu, ka taea e te tini o ngā whaea he mate ngākau te hapu me te whānau haumaru, ā, ka whānau mai he pēpi hauora.
