Antepartum: Maternal Hemorrhagic Causes & Disorders/1st Trimester: SPONTANEOUS ABORTION

Question 1

Vaginal Bleeding during pregnancy…normal ?

Answer 1

is always ABNORMAL and must be investigated to determine cause.

Question 2

Primary cause of bleedingFirst trimester (2)

Answer 2

1) Spontaneous abortion2) Ectopic pregnancy

Question 3

Primary cause of bleedingFirst trimester (2)Spontaneous AbortionLabs (4)

Answer 3

1) Hgb and Hct if considerable blood loss2) Clotting factors monitored for DIC3) WBC if infection is suspected4) Serum (hCG) levels to confirm pregnancy

Question 4

Diagnostic and Therapeutic Procedures (5)

Answer 4

1) Ultrasound determine viable, partial or complete2) Exam cervix3) D & C4) D & E after 16 weeks5) Prostaglandins and oxytocin (Pitocin)(ATI 67)

Question 5

Primary cause of bleedingFirst trimester: (2)Spontaneous abortion1) wksCramps, Bleeding, Tissue Passed, Cervical Opening2) Threatened3) Inevitable 4) Incomplete5) Complete6) Missed7) Septic8) Recurrent (ATI 66)

Answer 5

1)

Question 6

Primary cause of bleedingFirst trimester (2)Spontaneous AbortionIs vaginal exam indicated?

Answer 6

NO

Question 7

Primary cause of bleedingFirst trimester (2)Spontaneous AbortionNursing Actions

Answer 7

1) Bleeding color and amount2) Perform pregnancy test3) Bed rest, risk of fall due to sedation4) Assist with an ultrasound5) AVOID VAGINAL EXAM6) Adm blood products and meds7) Determine how much tissue has passed, save for exam8) Assist with termination of pregnancy

Question 8

Primary cause of bleedingFirst trimester (2)Assessment: Subjective and Objective Data

Answer 8

1) Backache and abd tenderness2) Ruptured membranes and dilation of the cervix3) Fever4) s/s of hemorrhage eg, hypotension and tachycardia

Question 9

Hypovolemic Shock aka

Answer 9

Hemorrhagic shock

Question 10

Hypovolemic Shock aka Hemorrhagic Shock1) What is it?2) What are the s/s?

Answer 10

1) Life threating, 20% of of body’s blood or fluid supply is loss2) Tachycardia, hypotension, weak pulse, diaphoretic, low or no urine output

Question 11

Primary cause of bleedingFirst trimester (2)Risk Factors

Answer 11

(ATI 66)

Question 12

Total Body Blood Volume

Answer 12

Average 5 liters

Question 13

Primary cause of bleedingFirst trimester (2)Spontaneous AbortionHealth Promotion and Disease PreventionDischarge Instructions

Answer 13

1) Notify HCP: Heavy, bright red vaginal bleeding2) Fever3) Expect discharge, normal for 1-2 wks4) Take antibotics5) Refrain from tub baths, sexual intercourse for 2 weeks6) Avoid becoming pregnant for 2 month