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OB > Chapter 4: Sophie Bloom (Preeclampsia) > Flashcards

Chapter 4: Sophie Bloom (Preeclampsia) Flashcards

1
Q

physical changes first trimester

A
  • Fatigue
  • Swollen tender breasts
  • Morning sickness
  • Cravings or aversions to certain foods
  • Moodiness
  • Constipation
  • More frequent urination
  • Headaches
  • Heartburn
  • Weight gain or loss
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2
Q

physical changes second trimester

A
  • aches and pains
  • linea nigra
  • darkening nipples and areola
  • hyperpigmentation
  • numbness/tingling of hands/fingers
  • itchy palms, soles, abdomen
  • heartburn
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3
Q

physical changes third trimester

A
  • heartburn
  • SOB
  • ankles, feet, face swelling
  • hemorrhoids
  • breast tenderness
  • colostrum
  • sleep disturbance
  • contractions
  • baby dropping
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4
Q

When can fetal heart tones be heard with a doppler?

A

10-12 weeks, normally about 110-160 bpm

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5
Q

Uses for ultrasound in the first, second, and third trimesters

A
  • Pregnancy dating
  • Fetal anomaly
  • Amniotic fluid
  • Placenta location
  • With procedures like amniocentesis
  • Assessment of fetal well-being
  • Assessment of vaginal bleeding
  • Cervical length evaluation
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6
Q

What not to consume in pregnancy and why

A
  • Raw food
  • Unpasteurized dairy products or juice
  • Large fish (mercury)
  • Raw sprouts
  • Alcohol
  • Tap water high in lead
  • Caffeine
  • BPA
  • Herbal teas or supplements unless approved
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7
Q

Expected fundal height at 12-, 16-, 20-, and 36 weeks gestation

A

fundal height in cm = gestational weeks from 12-36 weeks

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8
Q

How many weeks gestation for the anatomical ultrasound?

A

16-20 weeks

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9
Q

How many weeks gestation for TDaP immunization and RhoGAM administration?

A

28 weeks

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10
Q

How many weeks gestation for the oral glucose tolerance test?

A

24-28 weeks

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11
Q

What are the risk factors for preeclampsia?

A
  • Low or high age
  • African descent
  • Low socioeconomic status
  • Family or personal hx of preeclampsia
  • First pregnancy (nulliparity)
  • Pregnancy with new partner
  • UTI
  • Gestational diabetes
  • DM1
  • Obesity
  • Chronic HTN
  • Kidney disease
  • Thrombophilia
  • Abnormalities of fetus
  • Hydatidiform mole
  • Multifetal pregnancy (twins, triplets)
  • Donated eggs or sperm
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12
Q

What laboratory tests are ordered in preeclampsia?

A
  • UA or 24-hour urine collection
  • CBC: platelets
  • Liver enzymes ALT AST
  • BUN/Cre
  • CMP
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13
Q

What are typical standing orders (assessments, precautions) for patients that preeclampsia is being “ruled out”?

A
  • Minimal outside stimuli (seizure precautions)
  • FHR and uterine contraction monitoring
  • DTR and clonus
  • Vitals
  • Breath sounds, pulse ox, head to toe
  • Fetal ultrasound for BPP + amniotic fluid volume
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14
Q

what is clonus? how to assess and what does it look like?

A
  • beating of foot 3 or more times
  • assess by rapidly dorsiflexing (towards their nose) pt’s foot
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15
Q

what is an abnormal finding for reflexes in preeclampsia?

A

hyperactive (ex. hit below knee, pt kicks ya)

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16
Q

why do clonus and hyperactive reflexes occur with preeclampsia?

A

preeclampsia hyperstimulates the CNS

17
Q

What is the management of mild preeclampsia?

A
  • Deliver at 37 wks
  • Assessing for decreased fetal movement, increased swelling, epigastric pain, SOB, headache, vision change
  • Bp checks
  • Platelets and liver function tests
18
Q

What is magnesium sulfate used for in pregnancy? How is it given?

A
  • Prevent seizures or eclampsia
  • Given IV piggyback
19
Q

What are signs of magnesium toxicity?

A
  • resp depression
  • oliguria
  • absent reflexes
  • lethargy
  • slurred speech
  • muscle weakness
  • loss of consciousness
20
Q

what is a spinal?

A

single dose, lasts 1-3 hours

21
Q

what is a epidural?

A

indwelling catheter that allows for multiple doses or continuous by pump

22
Q

what is a spinal epidural?

A
  • single dose injected and then epidural catheter is placed
  • allows for more mobility
23
Q

What are the signs of hypotension from epidurals?

A
  • Decrease in BP or systolic 100 or less
  • Fetal bradycardia (below 120)
  • FHR variability decrease
24
Q

Nursing interventions for epidural hypotension?

A
  • Notify
  • Position on side
  • O2
  • Vasopressor
  • Elevate legs
  • Continue to monitor
25
Q

how to providers try to prevent epidural hypotension?

A

fluid bolus beforehand

26
Q

What needs to occur during the first period of reactivity for newborns?

A
  • HR 160-180 bpm, decreasing to 100-120 bpm
  • Alert and mobile

OB (7 decks)

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