Blue print Complication of pregnancy

Question 1

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

Answer 1

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

Question 2

Preeclampsia
Assessments

Answer 2

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

Question 3

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

Answer 3

For check HELLP
Hemolysis
Elevated liver enzymes
Low Platelets

Question 4

Preeclampsia
Interventions

Answer 4

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

Question 5

Preeclampsia
Medication

Answer 5

Magnesium sulfate
for prevent seizures
for vasodilation

Question 6

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

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

Answer 6

Preeclampsia
HELLP
Hemolysis
Elevated Liver enzymes
Lowe Platelets

Preeclampsia

Question 7

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

Answer 7

Delivery/only cure

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

Question 8

What is the waring sings?

Answer 8

Headache
Blurred vision
Epigastric pain(above berry)

Then eventually seizures

Question 9

Diabetes
Assessments

Answer 9

1 hr glucose test
then
3 hr glucose test

Question 10

1 hr glucose test
Abnormal range

Answer 10

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

Question 11

3 hr glucose
Abnormal range

Answer 11

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

Question 12

GDM
Nursing intervention

Answer 12

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

Question 13

GDM
What is the baby’s concern? 2

Answer 13

Hypoglycemia!!!!
Fetal macrosomia

Question 14

Preterm labor and PPROM
What is the risk and cause?

Answer 14

INFECTION!!!

Question 15

Preterm labor
a) definition
b) Risk for fetus

Answer 15

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

Question 16

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

Answer 16

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

Question 17

Preterm labor
Nursing interventions

Answer 17

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

DO NOT perform vaginal exam

Question 18

PPROM
a) definition
b) Risk for fetus

Answer 18

a) Spontaneous rupture before 37weeks
b) Prolapsed cord

Question 19

Prolapsed cord
What?
Why is bad?

Answer 19

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

Question 20

PPROM
Nursing interventions

Answer 20

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

DO NOT perform vaginal exam

Question 21

How is Cervical Insufficiency different from Preterm labor?

Answer 21

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

Question 22

Cervical Insufficiency
a) S/S
b) Mom risk

Answer 22

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

Question 23

Cervical Insufficiency
Nursing interventions

Answer 23

Assesses history of cervical trauma
History of PTL

Question 24

Multiple gestation
Which risk will increase?

Answer 24

GDM
Preeclampsia
Placenta previa
Placenta abruption

Question 25

Multiple gestation
Nursing interventions

Answer 25

Monitor ALL fetus FHR
Monitor ALL fetus sings of poor perfusion

Question 26

Danger sings on the 1st trimester
-Abnormal cramping
-Rupture of membrane
-Bleeding

Answer 26

Spontaneous abortion
occur before 20 weeks

Question 27

Danger sings on the 1st trimester
-Abrupt UNILATERAL pain
-bleeding

Answer 27

Ectopic pregnency

Question 28

2nd trimester bleeding sing

Answer 28

Cervical insufficiency

Question 29

3rd trimester
Difference blood type

Bright red
Painless
Uterus is soft

Answer 29

Placenta Previa
Placenta cover cervical opining

Question 30

Danger sings on the 1st trimester
-Uterine size increasing fast
-Abnormal high level of hCG
-N/V
-bleeding

Answer 30

Gestational Trophoblastic disease
A tumor develops inside the uterus

Question 31

3rd trimester
Difference blood type

Dark red
Sudden uterine pain
Uterus is firm

Answer 31

Abruption Placenta
Premature placenta separation

Question 32

Why Abruption Placenta more dangerous?

Answer 32

Hypovolemic shock
Medical emergency!!!!

Question 33

What is the risk trauma delivery?

Can be car accident
Intimate partner violence(IPV)

Answer 33

Immediate assessment starts with the ABCs
Intervention to prevent hypovolemia

Mom’s stabilize first!!!
Fetal assessment comes AFTER mom!!!

Question 34

ABCs?

Answer 34

Question 35

For IPV
What can we do?

Answer 35

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

Question 36

Education
For substance abuse
a) Mom risk
b) baby risk

Answer 36

Worse effect occur 1st trimester
How to quit safely

a) infection, nutrition imbalance
b) Infection cross placenta
Preterm delivery