Block 5 Pregnancy Complications Flashcards
What does AFP stand for and what does it do?
Alpha Fetoprotein test and it checks for spina bifida
What are some danger signs in pregnancy?
sudden gush of fluid. vaginal bleeding. abdominal pain. persistent vomiting. epigastric pain. edema of the face and hands. severe, persistent h/a. blurred vision or dizziness. chills with a fever over 100.4. painful urination or reduced urine output.
what should you do if you have a danger sign of pregnancy?
call the dr.
what three dangers of pregnancy could be a sign that the mother is getting ready to seize?
severe persistent headache. blurred vision or dizziness.
What is hyperemesis gravidarum?
excessive nausea and vomiting
this can impact fetal growth by the fetus not giving enough nourishment.
hyperemesis gravidarum
this can cause dehydration and reduced delivery of blood, oxygen, and nutrients to the fetus
hyperemesis gravidarum
what is the 1st rule of hyperemesis gravidarum
rule out other causes
What is the treatment of hyperemeis gravidarum
correct dehydration and electrolyte or acid imbalance. antiemetic drugs. TPN possibly. hospitalization possibly.
What treatment is provided if the hyperemesis gravidarum patient is hospitalized?
IVs and frequent small meals
what is the priority assessment in hyperemesis gravidarum?
I&O
What are the six types of spontaneous abortion?
threatened. inevitable. incomplete. complete. missed. recurrent.
what is another word for spontaneous abortion?
miscarriage
this type of abortion is when the cervix is dilated
inevitable
this is the type of abortion when everything is expelled
complete
this is the type of abortion when the fetus dies in the uterus and is not expelled at all.
missed
what are the two types of induced abortions
therapeutic and elective
what is a therapeutic abortion?
its done to save the mother. it is not spontaneous
what is an elective abortion?
an abortion done for other reasons other than to save the mother.
this happens in incomplete abortion
bleeding. cramping. cervical dilation. passage of some tissue.
What five interventions need to be done if a patient in the early stages of pregnancy starts bleeding?
document the amount and characteristics of bleeding
save anything that looks like clots or tissue for evaluation by a pathologist
perineal pad count with estimated amount of blood per pad..ex. 50%
monitor vitals
NPO in case of surgical intervention
this needs to be reported after an abortion
increased bleeding
how often does the temperature need to be taken after an abortion?
q8hr for 3days
this needs to be taken after an abortion
iron supplement
when can a patient resume sexual activities after an abortion
when the dr says
when can pregnancy occur after an abortion
before the first menstrual cycle
this may help the family work through grief
spiritual support of the family’s choice. ex.”im sorry” “would you like to talk”
what should not be said to a grieving patient
“i know how you feel”
most ectopic pregnancies occur in
the fallopian tubes
ectopic pregnancy can be caused from
scarring of tubal deformity
what is ectopic pregnancy
when the fetus develops outside of the uterus
s/s of ectopic pregnancy
lower abdominal pain.
s/s of tube rupturing
sudden sever lower abdominal pain.
vaginal bleeding
signs of hypovolemic shock(monitor vitals)
shoulder pain
treatments of an ectopic pregnancy
pregnancy test. transvaginal ultrasound. laparoscopic examination.
what is the priority of an ectopic pregnancy
control bleeding
what three actions can be taken in an ectopic pregnancy?
no action
treatment with methotrexate
surgery
s/s of hypovolemic shock
fetal HR changes tachycardia tachypnea hypotension decreased or absent urinary output (less than 30ml/hr) pale skin cold, clammy skin faintness thirst
manifestations of hydatidiform mole
bleeding rapid uterine growth failure to detect fetal HR signs of hyperemesis gravidarum higher than expected hCG levels
what causes the s/s of hyperemesis gravidarum in hydatidiform mole
increased hCG levels
what are the treatments of hydatidiform mole?
uterine evacuation. D&E.
why should the patient that had hydatifiform mole have follow up care for the next year?
because they can get cancer and because it can come back
placenta previa=
abnormal implantation of placenta
what is the s/s of placenta previa?
painless bleeding in late pregnancy. uterus is soft
abruptio placentae=
normal implantation of placenta. it detaches a little bit from the uterine wall
s/s of abruptio placentae
dark red bleeding and pain
what symptom distinguishes abruptio placentae from placenta previa?
pain
what needs to be observed in the pregnant women with excessive bleeding?
pain and uterine rigidity or tenderness
when does the doctor need to be called regarding the palpitation of the pregnant women with excess bleeding?
if the uterus is rigid or boardlike
hypertension is what BP?
greater than 140/90
risk factors for gestational hypertension(7)
1st pregnancy obesity age over 40 or under 19 multifetal pregnancy hypertension renal disease diabetes
2 s/s of gestational hypertension
edema above the waist. proteinuria. sudden weight gain.
gaining 18lbs by 31 weeks is
normal
treatment of gestational hypertension focuses on these two things
maintaining blood flow to the womans vital organs and to the placenta. preventing convulsions.
when does gestational hypertension end?
when the baby is born
5 conservative treatments for gestational hypertension
activity restriction(bed rest) maternal assessment of fetal activity(kick counts) BP Daily weight checking urine for protein
what are drug therapy treatments for gestational hypertension?
magnesium sulfate and antihypertensives
what is the antidote for magnesium sulfate?
calcium gluconaate
what is the therapeutic range for magnesium sulfate?
4-8
what needs to be monitored while on magnesium sulfate?
BP, deep tendon reflexes, I&O.
when does Rh incompatibility occur?
when the mother is Rh- and the baby is Rh+
when does erythroblastosis fetalis occur?
when the maternal anti Rh- antibodies cross the placenta and destroy fetal erythrocytes
what medication does erythroblastosis fetalis require?
RhoGAM
how often is RhoGAM required?
at 28 weeks gestation and within 72 hours to the mother after delivery. amniocentesis and misscarriage abortion
when does glucose return to normal in a women who has gestational diabetes?
by 6 weeks postpartum
what needs to monitored when the women has gestational diabetes
infections such as yeast infections or vaginitis(because of the sugar in the vagina). also monitor for polyandrosis
7 risk factors related to gestational diabetes
obesity large infant older than 25 previous stillbirth history of gestational diabetes in a previous pregnancy family history of diabetes fasting glucose over 126
what is the treatment for gestational diabetes(5)
diet monitor glucose levels ketone monitoring exercise fetal assessment more closely
what needs to be done if the woman discovers ketones in her urine?
call the dr.
a potential nursing dx for gestational diabetes would be…
risk for ineffective therapeutic regimen related to lack of knowledge
7 signs of CHF during pregnancy
cough moist lung sounds fatigue on exertion orthopnea edema palpitations changes in fetal HR
what can changes in fetal HR indicate?
hypoxia or growth restriction
what are the two nutritional types of anemia?
iron deficiency and folic acid deficiency
when should there be a cause of concern regarding the hemoglobin?
if it is less than 12
3 prevention interventions for iron deficiency anemia
iron supplements vitamin C(because it may enhance the absorption) do not take with milk or antiacids because calcium impairs absorption
what helps enhance absorption of Iron
vitamin C
what impairs absorption of Iron
calcium. ex. milk and antiacids
3 foods high in iron
oranges. strawberries. peppers.
TORCH=
infections that can be devastating to the fetus or newborn. toxoplasmosis other rubella cytomegalovirus herpes
what does Rubella cause in the fetus or newborn?
deafness, mental retardation and cataracts
what is the most common abused drug of pregnant women?
alcohol(ETOH)
what is the reasoning for increased trauma to women during pregnancy
increased violent society and more working women
