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Mother-Infant > ATI: Bleeding During Pregnancy > Flashcards

ATI: Bleeding During Pregnancy Flashcards

1
Q

What are the top 2 reasons for bleeding during the first trimester?

A
  1. Spontaneous Abortion
  2. Ectopic Pregnancie
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2
Q

What are some diagnostic and therapeutic procedures used in spontaneous abortion?

There are 5

A
  1. Ultrasound-visualizes whether the fetus is alive or dead
  2. Exam of cervix-Observe wheter it is opened or closed
  3. Dilation and Cutterage-dilate and scrape the uterine walls to remove urine contents
  4. Dilation and Evacuation-uterine contents are evacuated after 16 weeks of gestation
  5. Prostaglandins and oxytocin-augment or induce contractions to expulse products out
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3
Q

What client education do you give after a spontaneous abortion?

A
  • Dont have any sex for 2 weeks
  • Dont go into hottubs or hot baths
  • Dont put anything into vagina
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4
Q

Patient has unilateral stabbing pain and tenderness in lower abdominal segment and is early in pregnancy, what can this be an indication of?

A

Possible ectopic pregnancy

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5
Q

What is ectopic pregnancy?

What complication can this cause?

A

Implantation of a fertilized ovum outside the uterine cavity, usually in the fallopian tubes

Fatal hemorrhage

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6
Q

What specific expected finding / symptom may you expect in a woman experiencing in a worsening ectopic pregnancy?

A

Referred shoulder pain

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7
Q

When would medical management be used in an ectopic pregnancy?

A

When rupture has not occured and tuube preservation is desired

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8
Q

Salpingostomy

A

Done to save fallopian tube if not ruptured

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8
Q

What is methotrexate used for?

A

It ends ectopic pregnancy by inhibiting cell division and embryo enlargement

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9
Q

Laparoscopic salpingectomy

A

Removal of the tube, used when the tube has already ruptured

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10
Q

What are contraindications to taking methotrexate?

A

Client cannot take vitamins w/ folic acid

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11
Q

What are some risk factors for molar pregnancies?

A
  • Prior molar pregnancies
  • Teenagers or older than 40
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12
Q

Molar pregnancies can eventually lead to what?

A

Choriocarcinoma

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13
Q

What expected findings can we see in a client w/ gestational trophoblastic disease

A

Hyperemesis Gravidarum

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14
Q

What physical assessment findings can we see in a client with trophoblastic disease?

A
  • Increased uterine growth
  • Bleeding that is prune juice or dark brown
  • Anemia from blood loss
  • Preeclampsia before 24 weeks of gestation
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15
Q

What will an ultrasound reveal in a trophoblastic disease pregnancy?

A

Dense growth w/ vesicles, but no fetus in utero

16
Q

What follow up advise is important in molar pregnancies?

A

Client should follow up due to potential choricarcinoma risk

17
Q

What are the most common causes of bleeding in the second trimester of pregnancy?

A

Gestational trophoblastic disease

18
Q

What are the most common causes of bleeding in the third trimester of pregnancy?

A
  • Placenta previa
  • Abruptio placentæ
  • Vasa previa
19
Q

How would you expect the uterus to be in placenta previa?

A

Soft, relaxed, nontender

20
Q

How would you expect FHR and VS to be in placenta previa?

A

Normal and within baseline

21
Q

How can placenta previa be diagnosed w/ certainty?

A

Transabdominal or transvaginal ultrasound

22
Q

Can we do a vaginal manual exam w/ a client w/ suspected placenta previa?

A

No, because this may worsen the bleeding

23
Q

Client education for placenta previa?

A
  • Adhere to bedrest
  • Do not instert anything into the vagina
24
Q

What coagulation defect is assoc. w/ moderate to severe Abruptio placentæ?

A

Disseminated intravascular coagulopathy (DIC)

25
Q

What are some risk factors for Abruptio placentæ?

A
  • Maternal hypertension
  • Blunt trauma (car accident)
  • Cocaine use
  • Smoking
  • Previous Abruptio placentæ
26
Q

How is the uterus tone in Abruptio placentæ?

A

Firm and rigid

27
Q

What type of bleeding do we see in Abruptio placentæ?

A

Dark, port-wine red

28
Q

Do we see fetal distress in Abruptio placentæ?

A

Yes

29
Q

What is the management for Abruptio placentæ?

A

Birth

Mother-Infant (15 decks)

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