Complicated pregnancy NOTE Flashcards
Preterm labor
What that is?
Nursing goal?
a)
Uterine contractions and cervical changes
Between 20-36 weeks
b)
Stop or at least slow down before cervical changes and labor cannot stop
Preterm labor
Mom risk
Infection
Stress r/t baby’s condition
Fear
Pain r/t contractions
Preterm labor
Fetus risk
Mortality d/t respiratory maturely
Maturation deficiencies d/t Immature organ system
Preterm labor
Nursing implications
Monitor FHR
Monitor contraction pattern
Identify existing infection
Preterm labor
Education
Report sing
-uterine cramping
-bleeding
-low back pain
Limit activity to bathroom
Rest left side
Premature Rupture of membranes
PROM
Spontaneous rupture of membranes
before labor begins
After 37 weeks
PROM
Risk mom
Infection
Abnormal placenta
Hemorrhage
Sepsis and die
PROM
Risk fetus
Fetal sepsis (fetal)
Prolapsed cord
Poor placenta perfusion
PROM
PPROM
Nursing implications
Limit virginal exam
Asses temp every 2-4 hr
Asses fetal well being
Preterm Premature Rupture of Membrane
PPROM
Premature spontaneous rupture
before labor begins
after week 30 to 37weeks
PPROM
a) Risk Mom
b) Risk fetus
a) infection
b) Prolapsed cord
Fetal sepsis
Respiratory distress
Premature birth
Tachycardia
Prolapsed cord?
Occur if fetus is not engaged in pelvis
Requires C-section ASAP!!
Can result in a loss of oxygen to the fetus, and may even result in a stillbirth
d/t compression
Placentae previa
What that is?
Onset?
Pain?
Placenta placed lower cervical instead if the fundus
Quiet and sneaky onset
Painless!!
Placentae previa
Uterus?
Blood color?
Fundal heights?
soft and non tender
Bright red
Higher than normal
Abruptio Placenta
What that is?
Onset?
Pain?
Partial or completes separation
More dangerous!!
Sudden and stormy
Sever and steady
Abruptio Placenta
Uterus?
Blood color?
Fundal heights?
Firm and tenderness
Dark
Abruptio Placenta
Mom risk
Hypovolemic shock
Spontaneous bleeding
Death
Cervical insufficiency
Cervix opens too early during pregnancy
2 nd semester
Painless
-They don’t realized till they lost baby
Cervical insufficiency
Mom risk
Fetal risk
Guilt, shame
-because they didn’t notice till they lost the baby
Preterm deliver
Death
Cerclage
A procedure
Cervical openings is closed with stiches
They MUST notify when labor can be sing
First trimester risk
-12weeks
Spontaneous abortion before 20weeks
Ectopic pregnancy
Gestational Trophoblastic Disease
-Hydatidiform Mole
Gestational DM
Risk Mom
Difficulty labor
Preterm labor
PRM
Inc risk for c-section
Inc risk for infection
Gestational DM
Risk fetus
Preterm deliver
IUGR
Macrosomia
Shoulder dystocia
NICU admission
Respiratory distress
Hyperbilirubinemia
Gestational DM
Education
Perform daily kick counts
Maintain diet
Exercise
Change to oral to insulin
Preeclampsia
Initial sing
Headache
Vison change
Nausea
Edema
Dec featl movment
Preeclampsia
Worsening sing
Inc BP
Dec platelets
Dec u/o
Abruptio placenta d/t HTN
Preeclampsia
Why does it bad?
inc risk of placental abruptio
HELLP syndrome(Mom)
Poor placental perfusion d/t inc mom BP
Preeclampsia
Nursing intervention
The only cure is delivery!!31
Gestational diabetes
Baby risk at hypoglycemia after born
why??
Mom’s blood sugar was elevating even though it control
Baby was getting lots of sugar from mom
Now the baby is outside, no longer to get the sugar
Baby’s blood sugar CRASH!!!
Hyperemesis Gravidarum
a) S/S
b) NC
emesis=N/V
a) Weight loss is red flag
b) IV fluids
Hypoglycemia
S/S
Skin-cold and clammy need some candy!!
Hyperglycemia
S/S
Skin-warm and dry…. sugar high!!
