abortion exam 2 Flashcards
before 12 weeks gestation. Approximately 90% of abortions •endocrine imbalance: cystic fibrosis •infection: STD •genetic factors •systemic disorders: lupus, thyroid
early abortion
Ending of pregnancy before 20 weeks gestation
miscarriage
between 12 and 20 weeks gestation •Result from maternal causes •increased maternal age: >35 •increased parity: number of pregnancy's over 20 weeks •chronic infections: diabetes, PID •incompetent cervix •nutrition •recreational drug use
Late spontaneous abortion
bleeding
cervix closed
Threatened
increased bleeding and cramping cervix dilating (once it does this, it is considered)
inevitable
retention of some products of conception. May need D &
C.
(placenta stays in for 280, so may need DC when amniotic fluid and fetus comes out.)
Incomplete
all products of conception expelled
Complete
fetus dies, uterine growth ceases, brownish discharge, may
be weeks before contents fully expelled
Body thinks you’re still pregnant but no heart beat
Missed
3 or more consecutive spontaneous abortions
• Incompetent cervix
• Diabetes, infections, genetic factors
Recurrent or habitual
•Monitor all bleeding, save all clots or tissue, document blood loss •Monitor TPR, BP (hypovolemic show) •Teach client with threatened abortion S/S to report •increased bleeding •no intercourse, tampons, douching •report foul odor, discharge, malaise •monitor temp q 8 hours x 72 hours
Nursing care
•Assist with resources--home care during bed rest, counseling, support groups •Emotional support--loss will be grieved whether spontaneous or elective
More nursing care
- Dispel guilt
- Nothing patient did caused the miscarriage
- Acknowledge grief
- Feeling sad is appropriate in the death of their baby
- Recognize that each parent may express grief differently
- Anticipate anniversary grief in subsequent years
Caring for grieving family
- Reassure about future pregnancies
- Do not recommend any lifestyle changes at this time
- Keep in contact for support
- Phone or office visit within a few days to week
- Listening and sharing your own sadness is helpful
- Encourage notifying others who knew about the pregnancy
- Consider designating a friend to tell others
- Children should be told if they knew about pregnancy
More caring for grieving family