Blue print Complication of pregnancy Flashcards
a) Gestational HTN
b) Preeclampsia
c) Eclampsia
Abnormal range
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
Preeclampsia
Assessments
BP with appropriately sized cuff
Lab work
-liver and kidney function
-24hr urine for protein
Preeclampsia
Lab work for liver and kidney function baseline, why??
For check HELLP
Hemolysis
Elevated liver enzymes
Low Platelets
Preeclampsia
Interventions
Monitor U/O
Monitor vital
Monitor FRH
Monitor magnesium toxicity
Place lateral for inc perfusion
Preeclampsia
Medication
Magnesium sulfate
for prevent seizures
for vasodilation
HTN mom check kidney, liver and urine.
What is he testing for?
Kidney and liver were within normal range but show proteinuria, then what?
Preeclampsia
HELLP
Hemolysis
Elevated Liver enzymes
Lowe Platelets
Preeclampsia
If the mom is developing Preeclampsia, then what?
Dr also ordered Betamethasone IM with the deliver, why?
Delivery/only cure
To improve respiratory outcome
increasing surfactant production
Because early birth and the baby’s lung is matures
What is the waring sings?
Headache
Blurred vision
Epigastric pain(above berry)
Then eventually seizures
Diabetes
Assessments
1 hr glucose test
then
3 hr glucose test
1 hr glucose test
Abnormal range
> 140 then 3 hr test
200 no test needed, she is GDM
3 hr glucose
Abnormal range
Any 2 of below readings
Fasting >95
1hr >180
2hr>155
3h>140
GDM
Nursing intervention
Manage blood sugar
First life style, then insulin
Need to change oral to insulin
Encourage breastfeeding
GDM
What is the baby’s concern? 2
Hypoglycemia!!!!
Fetal macrosomia
Preterm labor and PPROM
What is the risk and cause?
INFECTION!!!
Preterm labor
a) definition
b) Risk for fetus
a) contraction occur between 20-36 weeks
b) death d/t mature respiratory
death d/t mature organ system
Preterm labor
ensure that pt knows when to call provider are?
Uterine contractions every 10 mins or more
Vaginal bleeding
Persistent Low back pain
Pelvic pressure
Preterm labor
Nursing interventions
Identify infection
Take temp every 2-4 hr
Monitor FHR
Monitor contractions
Promote bed rest
DO NOT perform vaginal exam
PPROM
a) definition
b) Risk for fetus
a) Spontaneous rupture before 37weeks
b) Prolapsed cord
Prolapsed cord
What?
Why is bad?
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
PPROM
Nursing interventions
Monitor FHR!!!
Bed rest!!!
Take temp every 2-4 hr
Monitor contractions
DO NOT perform vaginal exam
How is Cervical Insufficiency different from Preterm labor?
Painless!!! cervical dilation 2nd trimester
They don’t notice till they lost babies
Cervical Insufficiency
a) S/S
b) Mom risk
a) Bleeding
Painless
b) Guilt and shame d/t lost baby
Cervical Insufficiency
Nursing interventions
Assesses history of cervical trauma
History of PTL
Multiple gestation
Which risk will increase?
GDM
Preeclampsia
Placenta previa
Placenta abruption
Multiple gestation
Nursing interventions
Monitor ALL fetus FHR
Monitor ALL fetus sings of poor perfusion
Danger sings on the 1st trimester
-Abnormal cramping
-Rupture of membrane
-Bleeding
Spontaneous abortion
occur before 20 weeks
Danger sings on the 1st trimester
-Abrupt UNILATERAL pain
-bleeding
Ectopic pregnency
2nd trimester bleeding sing
Cervical insufficiency
3rd trimester
Difference blood type
Bright red
Painless
Uterus is soft
Placenta Previa
Placenta cover cervical opining
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
3rd trimester
Difference blood type
Dark red
Sudden uterine pain
Uterus is firm
Abruption Placenta
Premature placenta separation
Why Abruption Placenta more dangerous?
Hypovolemic shock
Medical emergency!!!!
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!!!
ABCs?
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
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
