Chapter - 26 & 27 High Risk ( Lecture Review ) Flashcards
What are the four broad categories of factors associated with high risk childbearing?
- Biophysical
- Psychosocial
- Sociodemographic
- Environmental
Factors grouped based on threats to health and pregnancy outcomes.
What does biophysical risk originate from?
Mother or fetus
May affect development and functioning of both.
List examples of biophysical factors that can affect high-risk pregnancy.
- Genetic disorders
- Nutritional status
- Medical or obstetric related illnesses
These factors can impact both mother and fetus.
What psychosocial factors are associated with high-risk pregnancy?
- Maternal behaviors
- Emotional distress
- Inadequate social support
These factors can lead to adverse lifestyles and relationships.
What sociodemographic factors can influence high-risk pregnancy?
- Lack of prenatal care
- Low income
- Marital status
- Ethnicity
These arise from the mother and her family.
What are some environmental hazards that can affect high-risk pregnancy?
- Chemicals
- Anesthetic gases
- Radiation
Hazards often found in the workplace.
What is the purpose of a daily fetal movement count (kick counts)?
To evaluate fetal well-being
A count of <3 kicks in 1 hour warrants further evaluation.
What is the most valuable diagnostic tool used in obstetrics?
Ultrasonography
Different levels of US include basic, limited, and specialized.
What does the biophysical profile (BPP) assess?
Fetal well-being
It includes factors like fetal heart activity and amniotic fluid volume.
What is amniocentesis used for?
- Genetic concerns
- Fetal maturity
- Disease diagnosis
It is a biochemical assessment technique.
What does the Coombs’ test detect?
Rh incompatibility and other antibodies
It identifies risks for fetal incompatibilities with maternal antigens.
What is the goal of the Nonstress test (NST)?
To determine if the intrauterine environment continues to support the fetus
Results can be reactive (normal) or nonreactive (requiring further evaluation).
What are the classifications of hypertensive disorders during pregnancy?
- Gestational HTN
- Preeclampsia
- Chronic essential HTN
These are the three most common types.
Define Gestational HTN.
HTN without other findings after 20 weeks
Blood pressure >140/90 that resolves after giving birth.
What characterizes preeclampsia?
HTN and proteinuria develop after 20 weeks in a normotensive woman
It can also develop for the first time in the postpartum period.
What is HELLP syndrome?
Hemolysis, elevated liver enzymes, low platelets
It can develop in women who do not have hypertension or proteinuria.
What are common risk factors for preeclampsia?
- Multifetal gestation
- History of preeclampsia
- Chronic HTN
- Preexisting diabetes
- Thrombophilias
Paternal factors may also contribute.
What is the initial intervention for a patient experiencing an eclamptic seizure?
Ensure patent airway
Note time of onset and duration of the seizure.
What is magnesium sulfate used for in the context of eclampsia?
Preventing or treating seizure activity
Requires careful monitoring of reflexes, respirations, and renal function.
What should be monitored during the administration of magnesium sulfate?
- Reflexes
- Respirations
- Renal function
It is a high alert medication.
What are the premonitory signs of eclampsia?
- Headache
- Blurred vision
- Epigastric pain
- Altered mental status
Convulsions can appear without warning.
What is the significance of hypertensive disorders during pregnancy?
Leading cause of maternal and perinatal morbidity and mortality worldwide
Occurs in 5-10% of all pregnancies.
What is the nursing action when a client at 36 weeks gestation presents with a constant headache and facial swelling?
Take the client’s blood pressure
This is the first action to assess for potential hypertensive disorders.
