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OB/GYN > Ch 37 Perinatal Loss > Flashcards

Ch 37 Perinatal Loss Flashcards

1
Q

Define miscarriage

A

Death of fetus before 20 weeks and weighing less than 350-500 grams

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2
Q

Define stillbirth

A

Death of fetus after 20 weeks, over 350-500 grams before birth

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3
Q

Define neonatal death

A

Death of any live-born infant within the first 28 days after birth

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4
Q

What is more important, weight or age, when determining miscarriage versus stillborn?

A

Weight

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5
Q

When do most miscarriages occur?

A

Usually before 12 weeks

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6
Q

What is the rate for stillbirths?

A

1 in 150

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7
Q

About __% of live births end in neonatal death

A

1%

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8
Q

Still birth rates are 2.3 times higher for __ than white women

A

non-hispanic black women

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9
Q

Stillbirth rates for asian and hispanic women are…

A

Asian 29%

Hispanic 14%

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10
Q

Fetal mortality is higher among which demographics of women

A

Teenagers
Women >35 years
Unmarried women
Multiple gestations

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11
Q

Most lethal fetal diagnoses are made at which gestational age?

A

18-20 weeks

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12
Q

How a fetal loss is perceived to parents will highly depend on …

A

How well-known the fetus is to the parent

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13
Q

Define grief

A

A process which bereaved persons go through to make meaning of their loss

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14
Q

What are the attribute of grief?

A

No time limit
Dynamic and involves complex emotions
Highly individualized
Pervasive, involving every aspect of a bereaved person’s life

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15
Q

How is still birth prevented?

A

Monitor of fetal movement after 24 weeks gestation (50% reduction)

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16
Q

What is ACOG recommendation for fetal kick counts?

A

Determine how long it takes to feel 10 kicks. Ideally want to feel 10 kicks within 2 hrs

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17
Q

What are the risk factors of stillbirth?

A 
Primiparity
AMA
Multiple gestation
Hypertensive disorders of pregnancy
Prematurity
UIGR
Obesity 
Smoking
18
Q

What are mental health associated with perinatal loss?

A

4x risk of depression
2x risk of anxiety
7x risk for PTSD

19
Q

What are mental health issues associated with perinatal loss?

A

Suicidal ideation
Divorce
Loss can last 10 years

20
Q

Perinatal loss is associated with the development of major physical health problems such as…

A

Hypertension, weight gain, DM, heart disease, substance abuse, suicide, and premature death

21
Q

What are risk factors for highly intense grief after perinatal loss?

A

Low social support
Previous psychiatric history
Termination for pregnancy for fetal anomalies
Perceive baby as a person

22
Q

What is the nurse’s role after perinatal loss?

A

Determine attachment, meaning, and related losses they are experiencing
History of prenatal loss
Mirror their language to discuss loss
Assess time to adjust and immediate responses
Determine social support

23
Q

When discussing perinatal loss use simple __ language

A

unambiguous

24
Q

What type of language should the nurse avoid when discussing perinatal loss?

A

euphemisms

25
Q

For early perinatal losses, what term should the nurse use?

A

miscarriage

26
Q

What should the nurse make sure to do before bringing the deceased baby to the parents?

A

Make sure the parents want to see and hold the baby

27
Q

Before the parents see the baby, the nurse should make sure to explain…

A

Any abnormalities they may see before showing the baby to them

28
Q

How should the nurse present the baby after a perinatal loss?

A

Bring the baby to them in a clean blanket, wrapped carefully

29
Q

It is important that the nurse treats the deceased baby like she would…

A

a baby who is alive

30
Q

What are the most distressing behaviors a nurse can exhibit to a patient dealing with perinatal loss?

A

Avoidance
Insensitivity
Poor communication

31
Q

How can nurses support parents dealing with perinatal loss

A

Give parents choice in their care whenever possible
Encourage them to discuss feelings
Obtain mementos

32
Q

Nurses should make parents aware that discussing their feelings with loved ones can result in…

A

Inadequate or inappropriate responses

33
Q

The nurse should discuss trigger events with parents such as…

A

Anniversary of baby’s death
Holidays
seeing pregnant women, baby isle etc

34
Q

If care does not mold to what the parent is feeling, they will feel

A

angry and victimized

35
Q

Most women experiencing perinatal loss cannot be assertive in their need and…

A

need their nurse to advocate for them

36
Q

If mother is not grieving, focus on comfort measures such as…

A 
Bleeding
Pain or cramping
Fear
Ask what they need
Preserve their dignity
37
Q

What are 4 things the nurse should do before caring for a patient after perinatal loss?

A
  1. Assess grief
  2. Shape experience to match what patient wants
  3. Assist them in the pass through unfamiliar events/decisions
  4. Determine preferences for the loss
38
Q

What scale is used to assess perinatal bereavement?

A

Perinatal Greif Intensity Scale

39
Q

What score on the perinatal grief intensity scale determines a woman is at risk for mental health issues and needs a referral for intervention?

A

Greater than or equal to 3.53

40
Q

What are the three sub scales of the perinatal grief intensity scale?

A

Reality (6 items)
Congruence (4 items)
Confront others (4 items)

41
Q

What type of scale does the perinatal grief intensity scale use?

A

4-point Likert scale ranging from strongly agree to strongly disagree

OB/GYN (11 decks)

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