Ch 19: Pregnancy Related Complications Flashcards
conditions that cause high risk pregnancies
diabetes, cardiac/resp disorders, anemia, autoimmune disorders, infections
what is hyperemesis gravidarum
severe form of nausea and vomiting during pregnancy
when do spontaneous usually occur
first trimester- due to fetal genetic abnormality
second trimester- related to maternal conditions
what are some nursing assessment findings we would see for Spontaneous Abortion
- vaginal bleeding
- cramping or contractions
- vital signs, pain level
- client’s understanding
completed abortion
all of the pregnancy tissue leaves the body and the cervix is close
incomplete abortion
some of the pregnancy tissue leaves the body but not all
inevitable abortion
cervix is dilated and the miscarriage is unavoidable
missed abortion
the pregnancy failed but the tissue did not leave the body
why would you use misoprostol (cytotec) related to abotion
stimulates uterine contractions to terminate a pregnancy and to evacuate the uterus after abortion to ensure passage of all the products of conception
why would you use RhoD immunoglobulin related to abortion
suppresses immune response of Rh- mom who is exposed to Rh+ blood after abortion, miscarriage, and pregnancy
what is an ectopic pregnancy
ovum implantation outside the uterus
hallmark sign of ectopic pregnancy
abdominal pain with spotting within 6-8 weeks after missed menses
therapeutic management for ectopic pregnancy
drugs: methotrexate (stops growth of fetus and it gets absorbed by fetus), prostaglandins, misoprostol, Rh immunoglobulin
what can bleeding or spotting in early pregnancy be a sign of
ectopic pregnancy
what can bleeding in second half of pregnancy be a sign of
less common and can indicate placenta previa, placental abruption, and vasa previa
what does HELLP syndrome stand for
Hemolysis, Elevated liver enzymes, Low platelt count
when does HELLP syndrome occur usually
usually in 3rd trimester but can occur anytime after 20 weeks onward
is HELLP the same as preeclampsia
HELLP is considered a severe form of preeclampsia
Preeclampsia also leads to high BP and proteinuria
signs of gestational diabetes
increased thirst and more frequent urination
complication for the infant of a mom with gestational diabetes
excessive birth weight, early preterm, breathing difficulties, hypoglycemia, obesity
what is blood incompatability and what is the most common
mom and baby have different blood types and mom’s will attack unborn baby’s red blood cells
usually mom has O and baby has A, B, or AB
biggest complications with blood incompatability
heart failure and miscarriage
but others include, fetal anemia, jaundice, organ damage,
most common treatment of blood incompatability
RhoGAM given at 28 weeks
Polyhydramnios
- what is it
- when does it happen
too much amniotic fluid over 2000ml
- popular in moms with multiple pregnancies (twins), congenital anomalies, or gestational diabetes
Oligohydramnios
- what is it
- when does it happen
too little amniotic fluid less than 500ml
- happens in late pregnancies, ruptures membranes, placental dysfunction
conditions associated with early bleeding during pregnancy
ectopic pregnancy, spontaneous abortion, cervical insufficiency
what is cervical insufficiency?
- when does this happen
premature dilation of cervix
- usually when baby is getting bigger and heavier if the woman has a weaker cervix and starts pressing
what test can determine cervical insufficiency
transvaginal ultrasound
Placenta previa
s/s
placenta covers cervical opening
- PAINLESS BRIGHT RED bleeding in second or third trimester
a mom with placenta previa should never get a
vaginal exams
Placental abruption
s/s
separation of placenta leading to compromised fetal blood supply
- dark blood, constant pain and uterine tenderness, fetal movement decreased, fetal distress
cardinal sign of placental abruption
sharp abdominal pain, rigid abdomen
severe preeclampsia mangement
oxytocin and mag sulfate, hospitalization
what is PROM
premature rupture of membranes 37+ weeks gestation
how is PROM diagnosed
speculum vaginal exam and then confirmed with nitrazine pH strip
How do you diagnose an ectopic pregnancy
Abdominal ultrasound
