405 5 Flashcards by Richard smith

Spontaneous Abortion is indicated by

bleeding between conception and 20 weeks’ gestation

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About 75% of spontaneous abortions occur between

8 and 13 weeks

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spontaneous abortions are usually r/t

chromosomal defects

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Spontaneous Abortion signs

Bright-red vaginal bleeding

cramping, backache, and pelvic pressure

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Spontaneous Abortion: major complication to watch for

shock

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Spontaneous Abortion: save all

peripads/linens

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Spontaneous Abortion: Start an

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Spontaneous Abortion: client should notify nurse of any tissue larger than a

dime

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Spontaneous Abortion: client should notify nurse of any discharge that is

foul smelling

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Spontaneous Abortion: implement grief protocol if fetus loss occurs: Provide a

memory packet (footprints, bracelet)

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Spontaneous Abortion: implement grief protocol if fetus loss occurs: allow family to

see the fetus

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Types of Spontaneous Abortion: spotting without cervical changes

Threatened

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Tx of Threatened Spontaneous Abortion

bed rest for 24 to 48 hours; no sexual intercourse for 2 weeks

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Gestational Trophoblastic Disease is aka

Hydatidiform Mole

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Hydatidiform Mole: ____ ___ degenerate into a bunch of clear vesicles in grapelike clusters

Chorionic villi

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Hydatidiform Mole predisposes the client to

cancer

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Signs of Hydatidiform

bleeding in 1st trimester

Uterus larger than expected for GA

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Hydatidiform Mole: Instruct to prevent pregnancy for

1 year

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Hydatidiform Mole: Instruct to obtain monthly

serum hCG levels for 1 year

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Hydatidiform Mole: If hCG levels don’t diminish, you could develop

cancer

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Ectopic Pregnancy sign: possible absence of

normal early pregnancy symptoms

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Ectopic Pregnancy sign: Pregnancy test is

positive

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3 Ectopic Pregnancy signs:

Missed period
Full feeling in lower abd
Lower quadrant tenderness

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Ectopic Pregnancy complication: Acute rupture: signs

Abd mass
sharp pain
Fainting
Shock
Shoulder pain

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Ectopic Pregnancy: perform gentle

palpation and percussion

Ectopic Pregnancy: prepare client for abdominal

ultrasound

Ectopic Pregnancy: prepare client for possible

laparotomy

Ectopic Pregnancy: type and crossmatch client for

2 units packed RBCs

Suspect ectopic pregnancy in any woman

of childbearing age who comes to the hospital with abd pain

Abruptio Placentae

the placenta prematurely detaches from the uterus

Placenta Previa

the placenta attaches to the wrong part of the uterus (the lower part)

Placenta Previa is associated with

previous uterine scars, surgery, and fibroid tumors

Abruptio Placentae abd

rigid

Placenta Previa uterus feels

soft

Abruptio Placentae FHR

abnormal

Placenta Previa FHR

normal

Abruptio Placentae: First intervention

bed rest | No vaginal/rectal, abd manipulation

Placenta Previa: First intervention

Extended bed rest until the fetal lungs are mature, then delivery No vaginal/rectal, abd manipulation

Abruptio Placentae: watch for signs of DIC which are

bleeding/bruising anywhere | decreased lab values (platelets, PT, fibrino)

Abruptio Placentae: prepare for emergency

C section

Tetracycline and pregnancy

contraindicated because it darkens the baby's teeth

Toxoplasmosis is usually r/t

cats

Maybe the biggest factor in having a successful teen pregnancy

nutrition

Preterm Labor definition

labor between 20 and 37 weeks

Preterm Labor risk factor: Infection, especially

UTI

Preterm Labor psychosocial risk factor:

any kind of stress

warning signs of preterm labor: Uterine contractions every

10 minutes or more often

warning signs of preterm labor: more than __ contractions in an hour

Preterm Labor: Teach need for bed rest with fetus off of the cervix (e.g., no ___ or ____).

sitting or kneeling

Preterm Labor: to increase uterine perfusion position side-lying and

elevation of feet

Preterm Labor: during labor, teach to empty bladder every

2 hours

Preterm Labor: medication that's used because it decreases uterine activity through relaxation of smooth muscle

Magnesium sulfate

Gestational hypertension: There is no

proteinuria

Gestational hypertension: BP elevation occurs for the first time after

midpregnancy

Transient hypertension definition

It resolves by 12 weeks after birth

Preeclampsia usually occurs after

week 20

Preeclampsia involves gestational hypertension plus

proteinuria

HELLP syndrome

Hemolysis, elevated liver enzymes, low platelets

Although not technically classified as a separate hypertensive disorder of pregnancy, HELLP syndrome is a variant of severe

preeclampsia

Eclampsia

Seizures in a woman with preeclampsia

magnesium sulfate antidote

calcium gluconate

the major side effect of tocolytic drugs

tachycardia

tocolytic definition

drug that suppresses premature labor

Chronic hypertension

Hypertension has been observed before pregnancy or is diagnosed before the 20th week of gestation

Preeclampsia is characterized by a BP greater than

140/90

When does Preeclampsia usually develop

during the last 10 weeks or up to 48 hours post delivery

Preeclampsia occurs predominantly in

primigravida and in multigravida if experienced as a primigravida

preeclampsia patho: Generalized

vasoconstriction

preeclampsia patho: involves the loss of

plasma protein into the interstitial spaces (fluid is drawn into the extravascular spaces, which results in hypOvolemia)

preeclampsia: there is decreased perfusion because of the

hypOvolemia

preeclampsia risk factor: Poor ____ intake

protein

preeclampsia assessment: how will they look at first glance

edema of the face and fingers

preeclampsia assessment: weight

gaining more than 2 pounds a week

HELLP syndrome: Many women are ____ and do not have ____

normotensive | proteinuria

Even if HTN is absent, women with HELLP syndrome should be treated prophylactically with

magnesium sulfate

The chances that someone with HELLP will get it again in another pregnancy

high

Antepartum Preeclampsia care: Home management

Inform client that absolute bed rest with bathroom privileges is necessary

Antepartum Preeclampsia care: client should report weight gain of

more than 2 lbs

Antepartum Preeclampsia care: at home the client should test herself for

proteinuria

Antepartum Preeclampsia care: diet

high protein and low salt

Antepartum Preeclampsia care: environment should be

quiet and dim

Antepartum Preeclampsia care: Check for _____ under BP cuff

Petechiae

Intrapartum Preeclampsia care: Keep nurse-to-client ratio at

1:1

Intrapartum Preeclampsia care: activity level/position

absolute bed rest, side-lying and with | side rails up.

Intrapartum Preeclampsia care: Check urine for protein every

hour

Intrapartum Preeclampsia care: Check DTR every

hour

Intrapartum Preeclampsia care: administer

magnesium sulfate

Intrapartum Preeclampsia care: If convulsions or seizures do occur: Do not attempt to

insert something in the mouth

The 2 main goals for preeclampsia is

maintain perfusion to the uterus and prevent seizures

Preeclampsia care: antiHTN drugs are rarely used, but if they are the drug of choice is

hydralazine

Preeclampsia care: antiHTN drugs are rarely used, but if they are it's because the diastolic BP was above

110

Preeclampsia: although delivery is said to be the "cure" the client can still

seize up to 48 hours after