Blue print Complication of pregnancy Flashcards

1
Q

a) Gestational HTN
b) Preeclampsia
c) Eclampsia
Abnormal range

A

a) BP>140/90 after 20weeks
NO proteinuria !!!!!!
b) BP>140/90 proteinuria >1+
c) BP>160/90 proteinuria >3+

*** HTN=vasoconstriction= poor placenta perfusion

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2
Q

Preeclampsia
Assessments

A

BP with appropriately sized cuff
Lab work
-liver and kidney function
-24hr urine for protein

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3
Q

Preeclampsia
Lab work for liver and kidney function baseline, why??

A

For check HELLP
Hemolysis
Elevated liver enzymes
Low Platelets

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4
Q

Preeclampsia
Interventions

A

Monitor U/O
Monitor vital
Monitor FRH
Monitor magnesium toxicity
Place lateral for inc perfusion

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5
Q

Preeclampsia
Medication

A

Magnesium sulfate
for prevent seizures
for vasodilation

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6
Q

HTN mom check kidney, liver and urine.
What is he testing for?

Kidney and liver were within normal range but show proteinuria, then what?

A

Preeclampsia
HELLP
Hemolysis
Elevated Liver enzymes
Lowe Platelets

Preeclampsia

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7
Q

If the mom is developing Preeclampsia, then what?
Dr also ordered Betamethasone IM with the deliver, why?

A

Delivery/only cure

To improve respiratory outcome
increasing surfactant production
Because early birth and the baby’s lung is matures

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8
Q

What is the waring sings?

A

Headache
Blurred vision
Epigastric pain(above berry)

Then eventually seizures

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9
Q

Diabetes
Assessments

A

1 hr glucose test
then
3 hr glucose test

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10
Q

1 hr glucose test
Abnormal range

A

> 140 then 3 hr test
200 no test needed, she is GDM

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11
Q

3 hr glucose
Abnormal range

A

Any 2 of below readings
Fasting >95
1hr >180
2hr>155
3h>140

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12
Q

GDM
Nursing intervention

A

Manage blood sugar
First life style, then insulin
Need to change oral to insulin
Encourage breastfeeding

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13
Q

GDM
What is the baby’s concern? 2

A

Hypoglycemia!!!!
Fetal macrosomia

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14
Q

Preterm labor and PPROM
What is the risk and cause?

A

INFECTION!!!

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15
Q

Preterm labor
a) definition
b) Risk for fetus

A

a) contraction occur between 20-36 weeks
b) death d/t mature respiratory
death d/t mature organ system

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16
Q

Preterm labor
ensure that pt knows when to call provider are?

A

Uterine contractions every 10 mins or more
Vaginal bleeding
Persistent Low back pain
Pelvic pressure

17
Q

Preterm labor
Nursing interventions

A

Identify infection
Take temp every 2-4 hr
Monitor FHR
Monitor contractions
Promote bed rest

DO NOT perform vaginal exam

18
Q

PPROM
a) definition
b) Risk for fetus

A

a) Spontaneous rupture before 37weeks
b) Prolapsed cord

19
Q

Prolapsed cord
What?
Why is bad?

A

Occurs if fetus is not engaged in pelvis
Requires immediate c-section

Compression of the cord results in vasoconstriction and resultant fetal hypoxia, which can lead to fetal death

20
Q

PPROM
Nursing interventions

A

Monitor FHR!!!
Bed rest!!!
Take temp every 2-4 hr
Monitor contractions

DO NOT perform vaginal exam

21
Q

How is Cervical Insufficiency different from Preterm labor?

A

Painless!!! cervical dilation 2nd trimester
They don’t notice till they lost babies

22
Q

Cervical Insufficiency
a) S/S
b) Mom risk

A

a) Bleeding
Painless
b) Guilt and shame d/t lost baby

23
Q

Cervical Insufficiency
Nursing interventions

A

Assesses history of cervical trauma
History of PTL

24
Q

Multiple gestation
Which risk will increase?

A

GDM
Preeclampsia
Placenta previa
Placenta abruption

25
Multiple gestation Nursing interventions
Monitor ALL fetus FHR Monitor ALL fetus sings of poor perfusion
26
Danger sings on the 1st trimester -Abnormal cramping -Rupture of membrane -Bleeding
Spontaneous abortion occur before 20 weeks
27
Danger sings on the 1st trimester -Abrupt UNILATERAL pain -bleeding
Ectopic pregnency
28
2nd trimester bleeding sing
Cervical insufficiency
29
3rd trimester Difference blood type Bright red Painless Uterus is soft
Placenta Previa Placenta cover cervical opining
30
Danger sings on the 1st trimester -Uterine size increasing fast -Abnormal high level of hCG -N/V -bleeding
Gestational Trophoblastic disease A tumor develops inside the uterus
31
3rd trimester Difference blood type Dark red Sudden uterine pain Uterus is firm
Abruption Placenta Premature placenta separation
32
Why Abruption Placenta more dangerous?
Hypovolemic shock Medical emergency!!!!
33
What is the risk trauma delivery? Can be car accident Intimate partner violence(IPV)
Immediate assessment starts with the ABCs Intervention to prevent hypovolemia Mom's stabilize first!!! Fetal assessment comes AFTER mom!!!
34
ABCs?
35
For IPV What can we do?
A alone Your not alone B belief Not your fault C confidentiality We cannot report D Documentation E Education Community resources S Safety call 911 if she seems danger after discharge
36
Education For substance abuse a) Mom risk b) baby risk
Worse effect occur 1st trimester How to quit safely a) infection, nutrition imbalance b) Infection cross placenta Preterm delivery