Bleeding disorders Flashcards
door of the uterus
cervix
another word for bleeding disorders
hemorrhagic disorders
termination of pregnancy
before 20 wks
fetus is <500 g
abortion
social reasons for abortion (choice)
therapeutic reasons for abortion (illness to mother)
elective abortion
abortion due to natural causes
spontaneous
cervix is closed
spotting occurs
threatened abortion
cervix dilated
contents come out of uterus
inevitable abortion
fetus comes out but placenta is contained
problem for risk of infection (retained POC)
incomplete abortion
no POC retained
complete abortion
3 or more successive abortions
habitual
what could be the cause of habitual
cervical incompetence/insufficiency
cervix opens for no reason
can put in small suture to attempt to keep it closed
cervical incompetence
when do ectopic pregnancies usually occur
first trimester only
fertilized ovum s implanted outside uterine cavity
usually tubal but not always
ectopic pregnancy
what is the only place capable for developing a fetus
body of uterus
can an ectopic pregnancy be transferred
no, will not carry to term
what are the types of ectopic pregnancies
cervical, abdominal, ovarian, interstitial, isthmic, ampullar, fimbrial, tuboovarian
what are the CC of ectopic pregnancies
unilateral sharp abdominal pain (if tubal preg)
what will happen if ectopic pregnancy not identified
will rupture which will lead to SHOCK or massive hemorrhage
what are women with ectopic pregnancies given to terminate the pregnancy
methotrexate
what does FHT stand for
fetal heart tones
what is another word for trophoblastic disease
hydatidiform mole
what is important to remember for hydatidiform mole
NO embryo NO fetus
benign degenerative process of placenta
chronic villi degenerate into edematus, cystic, avascular transparent vesicles that hang in grape like clusters
trophoblastic disease
does trophoblastic disease count as a pregnancy
YES
even though no fetus
chromosomes were incorrect
fertilization of egg with no nucleus and no DNA
sperm nucleus duplicates itself
mole grows rapidly
created degenerative placenta
complete mole
what can happen to a degenerative placenta
can rupture uterus
can cause vaginal expulsion of vesicles
FERTILIZATION of normal egg with two sperm
mole grows rapidly
may have embryonic or fetal parts
partial mole
what are two sperms (too much) called
triploid
S/S of trophoblastic disease
abnormal uterine bleeding uterus larger than dates anemia from blood loss excessive vomitting abdominal cramps preeclampsia prior to 20 wks no FHT or fetal skeleton
sequelae of trophoblastic disease
high risk for choriocarcinoma
malignancy, 15-20 % of women have evidence of persistent gestational trophoblastic
what are choriocarcinoma patients given
prohoylactic chemo
methotrexate
what position do we want the placenta in
high in fundus
what lead to pregnancy loss
abortion, ectopic, and molar
women with pregnancy loss need what
support and counseling
placenta is malpositioned and attached in the lower uterine segment rather than the fundus
placenta previa
placenta may migrate upward during pregnancy
extends to cervical OS
marginal/low lying (placenta previa)
placenta partially covers cervical OS
partial (placenta previa)
placenta completely covers cervical OS
total (placenta previa)
what do you need to do if placenta previa found
C section
CANNOT deliver placenta before baby as baby will not have oxygen
S/S of placenta previa
bright red vaginal bleeding
uterine tone is normal
PAINLESS
premature separation of the placenta BEFORE birth
abruptio placenta
small tear on placenta which clotted off
no clotting and no apparent vaginal bleeding
partial abruptio placenta
placenta completely off uterine wall
may be concealed or frank bleeding
complete abruptio placenta
S/S of abruptio placenta
dark uterine bleeding (concealed or apparent)
RIGID boardlike abdomen
PAINFUL-uterine/abdominal tenderness
is abruptio placenta a medical emergency
YES, URGENT
may cause loss of life to mother and fetus
this is a key hint of hemorrhage
Wide pulse (catch BEFORE escalates)
first bleeding assessment
where is the bleeding coming from
second bleeding assessment
how much blood is coming out?
measure in peripad saturation over time
third bleeding assessment
change in vital signs?
what vital signs are you watching for when bleeding?
1) widened pulse pressure (increase in BP?)
2) elevated HR (tachy)
3) change in BP (decrease in BP, systolic and diastolic)
interventions for bleeding
1) call for help
2) give O2 per 10 L non rebreather
3) start IV lines and hang fluid replacement
4) monitor for FHT and be ready for potential surgery
5) monitor VITALS
MAJOR responsibility of nurse during bleeding
start 1 or 2 large bore IV lives and hang fluid replacements
