COMPLICATIONS OF MATERNITY

Question 1

Miscarriage (Spontaneous abortion):
1. 2 S/S:
• _____ and _______
______ is common during pregnancy but the combination of __________and
______________ is more indicative of a miscarriage.

Answer 1

1. S/S:
   Spotting and cramping
   Spotting is common during pregnancy but the combination of ____spotting_and
   ______cramping_ and complaining of back ache_ is more indicative of a miscarriage.

Question 2

Tx for miscarriage

Tx:

a. Measures hCG levels- we worry when levels __________________
b. Bedrest and __________ rest (abstinence from sex)
c. If miscarriage imminent→IV,Blood,D&C(dilatation&;curettage)

Answer 2

2. Tx:
   a. Measures hCG levels- we worry when levels _DROP
   b. Bedrest and _______ PELVIC___ rest (abstinence from sex)
   c. If miscarriage imminent → IV, Blood, D &C (dilatation & curettage)— this is where they go ahead and remove the remaining product that Are left during conception

Question 3

B. Hydatidiform mole (molar pregnancy):

Patho:
3 characteristic

Answer 3

Patho:

a. Benign neoplasm, can turn malignant
b. Grape-like clusters of vesicles
c. May/may not have a fetus involved (for NCLEX purpose no fetus is involve

Question 4

How does Hydatidiform mole pregnancy start?

Starts off as a normal pregnancy but
• Uterus enlarges too _____

Answer 4

Fast

Question 5

Hydatidiform mole 2 s/s

Answer 5

S/S:

a. Absence of FHTs
b. Bleeding (sometimes will have vesicles) in discharge

Question 6

Dx: for Hydatidiform mole

• Confirmed with ________

Answer 6

Dx:

Confirmed with _____ Ultrasound_

Question 7

5 tx for Hydatidiform mole

5. Tx:
   a. Small mole → D&;;C (have to empty the uterus)
   b. Do not get _______________________during follow up time; follow-up is very important
   c. Ifitbecomesmalignantitiscalledchoriocarcinoma.
   d. Will do ____________ ________________ to determine metastasis.
   e. Will measure hCGs_____until normal;recheckedq2-4weeks;then every 1-2 months for 6 months to a yearlong r.

Answer 7

Tx:
a. Small mole → D&;C (have to empty the uterus)
b. Do not get ______________pregenant___during follow up time; follow-up is very pimportant
c. If it becomes malignant it is called choriocarcinoma.
d. Will do _________chest X-rays ___ to determine metastasis.
e. Will measure hCGs _________weekly____ until normal; rechecked q 2-4 weeks; then
every 1-2 months for 6 months to a year.

Question 8

Patient has told not to get pregnant during follow up time because

Answer 8

Patient is pregnant HCG levels normally go up but if metastasis or malignancy is present the doctor won’t be able to determine if is the pregnancy that causes the rise in a hCG levels of is it the malignancy

Question 9

Ectopic Pregnancy: 1. Definition:

a. This is a gestation outside of the ______________________.
b. Where does it usually occur? ________.
c. Confirmed with an____________________

Answer 9

Ectopic Pregnancy:

1. Definition:
   a. This is a gestation outside of the __ uterus __.
   b. Where does it usually occur? Fallopian tube.
   c. Confirmed with an ____________ultrasound

Question 10

: Ectopic Pregnancy:
a. First sign?
b. Client will usually exhibit the usual
S/S of ________________ … then pain, spotting or may be bleeding into the peritoneum.
• If the fallopian tube ruptures, vaginal bleeding may be present.

c. If a client has had 1 ectopic pregnancy she is at risk for another.

Answer 10

S/S:
a. First sign? Pain
b. Client will usually exhibit the usual S/S of ________prgenancy__ … then pain,
spotting or may be bleeding into the peritoneum.
If the fallopian tube ruptures, vaginal bleeding may be present.

Question 11

Ectopic Pregnancy: tx

:the goal is to ____ save the tube
a. Methotrexate (Rheumatrex®/Trexall®) is given to Mom to _____ the growth of the
embryo to _____ the tube.

b. If the Methotrexate (Rheumatrex®/Trexall®) does not work, a _____ incision will be made into the tube and the ______ will be removed.

C.• The entire tube may have to be removed.

A ____ is done if the tube has ruptured or if ectopic pregnancy is advanced.
• If the tube does rupture what are you worried about? __________

Answer 11

3. Tx:
   a. Methotrexate (Rheumatrex®/Trexall®) is given to Mom to stop the growth of the Embryo to save the tube.

b. If the Methotrexate (Rheumatrex®/Trexall®) does not work, a laparoscopic
incision will be made into the tube and the embryo will be removed.
The entire tube may have to be removed.

c. A laparotomy is done if the tube has ruptured or if ectopic pregnancy is advanced.
If the tube does rupture what are you worried about? __they may hemorrhage and need a blood transfusion

Question 12

Placenta Previa:

1. Patho:
   a. Most common cause of ___________________ in the later months (usually the ___th)
   b. The placenta has ______ wrong.
   c. An___________________________will be done to confirm placental location

Answer 12

Placenta Previa:
1. Patho:
a. Most common cause of _________bleeding in the later months (usually the
7th)
b. The placenta has implanted wrong.
c. An ____________ultrasound___ will be done to confirm placental location

Question 13

How does this happen? Placenta previa
a. The placenta begins to prematurely separate when the cervix begins to dilate and efface →____________ doesn’t get oxygen

b. Normally, the placenta should be attached where in the uterus? _____________
• The placenta may be on the side of the uterus (low lying placenta), halfway covering the cervix (partial previa), or completely covering the cervix (complete previa).
• The problem is, what is coming out first? _______________________

Answer 13

2. How does this happen?
   a. The placenta begins to prematurely separate when the cervix begins to dilate and
   efface →________baby__ doesn’t get oxygen
   b. Normally, the placenta should be attached where in the uterus? ____up high in the uterus___
   The placenta may be on the side of the uterus (low lying placenta),
   halfway covering the cervix (partial previa), or completely covering the
   cervix (complete previa).

No matter the location
The problem is, what is coming out first? __the placentas And this is not going to be a normal delivery

Question 14

S/s of placenta previa

Answer 14

S/S:

Painless bleeding in 2 nd half of pregnancy (may be spotting or may be profuse)

Question 15

7 Tx for placenta previa

Complete previa usually requires hospitalization (from as early as 32 weeks until birth) to prevent blood loss and fetal ______________ if client goes into labor

If there’s not much bleeding→ _______________ and watch very close.

Rule out other sources of bleeding like abruption.
_______ counts

The Monitor blood count and monitor _____________ closely.

Monitor for contractions → call MD (not going to be a normal delivery) Delivery method of choice? __________ _____________
Do not perform ___________________________ exam

Answer 15

4. Tx:
   a. Complete previa usually requires hospitalization (from as early as 32 weeks until
   birth) to prevent blood loss and fetal ___ hypoxia__ if client goes into labor
   b. If there’s not much bleeding→ ____bedrest and watch very close.
   c. Rule out other sources of bleeding like abruption.
   d. _____pad__ counts
   e. Monitor blood count and monitor ______baby_ closely.
   f. Monitor for contractions → call MD (not going to be a normal delivery)
   g. Delivery method of choice? c section

Question 16

4 Fetal Complications:

Answer 16

Fetal Complications:

a. Preterm delivery
b. Intrauterine growth retardation
c. Fetal distress
d. Anemia

Question 17

Maternal Complications:

Answer 17

Maternal Complications:

a. Hemorrhage
b. Potential DIC risk

Question 18

Abruptio Placenta:

1. Patho:
   a. Is the placenta implanted normally? _______
   b. May be partial or _________________
   c. It separates prematurely→bleeds(external or concealed)
   • Concealed means bleeding into the _________________. d.

Seen in ___ _____ of pregnancy
e. _________________to confirm the diagnosis
• May be partial or complete
• Severity is based on a scale of 1-3 with 3 being the worst.

Answer 18

1. Patho:
   a. Is the placenta implanted normally? _yes
   b. May be partial or __complete__
   c. It separates prematurely→ bleeds (external or concealed)
   Concealed means bleeding into the _________uterus___.
   d. Seen in last half of pregnancy
   e. _______________ultrasound__ to confirm the diagnosis
   May be partial or complete
   Severity is based on a scale of 1-3 with 3 being the worst.

Question 19

5 Causes of Abruptio Placenta:

a. MVC= motor vehicle crash
b. Domestic violence
c. Previous Cesarean Section
d. Rapid decompression of the uterus (membranes rupture)
e. Associated with _____, PIH, ; _________

Answer 19

2. Causes:
   a. MVC= motor vehicle crash
   b. Domestic violence
   c. Previous Cesarean Section
   d. Rapid decompression of the uterus (membranes rupture)
   e. Associated with _______cocaine___, PIH, &_______smoking___

Question 20

S/S of Abruptio Placenta:

Answer 20

3. S/S:
   a. Abdominal _____pain______ and increased uterine tone.
   b. Rigid board-like abdomen, with or without vaginal bleeding.
   c. Difficult to palpate fetus.

Question 21

Tx for Abruptio Placenta:

Answer 21

4. Tx:
   a. Method of delivery? CS
   RULE: Do not do vaginal exams in the presence of unexplained
   vaginal bleeding

Question 22

Incompetent Cervix:

Patho:
a. This is when the cervix _________________________ prematurely.
b. Occurs in the ________________ month of pregnancy
c. This client will have a history of repeated,painless,______________trimester
miscarriages.

Answer 22

Patho:
a. This is when the cervix ________ dilates prematurely.
b. Occurs in the ________4th_ month of pregnancy
c. This client will have a history of repeated, painless, _____second___ trimester
miscarriages.

Question 23

Cause of Incompetent Cervix:

Answer 23

The weight of the baby causes pressure on the cervix causing it to prematurely dilate

Question 24

Incompetent Cervix 3 TX

• A Purse-String suture (cerclage) at 14-18 weeks – reinforces the ___________
• May have a c-section to preserve the suture
• Some physicians clip the suture so the client can deliver vaginally
• 80-90% chance of carrying the baby to __________ after cerclage.

Answer 24

Tx:
a. Purse-String suture (cerclage) at 14-18 weeks – reinforces the cervixs
b. May have a c-section to preserve the suture
Some physicians clip the suture so the client can deliver vaginally
c. 80-90% chance of carrying the baby to ___term_ after cerclage.

Question 25

Hyperemesis Gravidarum. Patho a. Starts like regular morning __________________ b. Excessive vomiting→ dehydration→ starvation→ ________________

Answer 25

a. Starts like regular morning ______sickness___ | b. Excessive vomiting→ dehydration→ starvation→ ______death related to high levels of estrogen and Hgc_

Question 26

Hyperemesis Gravidarum Causes: • R/T high levels of estrogen &;; ____________________

Answer 26

Causes: | R/T high levels of estrogen & ________hgc_

Question 27

S/S: Hyperemesis Gravidarum a. What happens to the: BP________ H/H________ UO ________ K+_______ Weight________ b. What will they have in their urine? _____________ • Why is there acetone (ketones) in the urine?

Answer 27

S/S: a. What happens to the: BP__down__ H/H_up UO ____down__ K+__down Weight_______down_ b. What will they have in their urine? ___kentones Why is there acetone (ketones) in the urine Because breakdown body fat

Question 28

11 for Tx for Hyperemesis Gravidarum a. NPO for ________________________ b. IVFs __________________ml for 1st 24 hours c. Antiemetic d. Vitamins e. Environment?_________________________ f. Oral hygiene g. Is it okay to talk about food? ___________________ h. Why should the emesis basin be kept out of sight? ______________________ i. 6-8 small, dry feedings followed by ________________ ________________ j. Foods/liquids should be ________________ or ______________ k. Well-ventilated room

Answer 28

4. Tx: a. NPO for ________________48hrs_ b. IVFs _______________3000 ccc___ml for 1st 24 hours c. Antiemetic d. Vitamins e. Environment? ___________quiet_ f. Oral hygiene g. Is it okay to talk about food? __________no__ h. Why should the emesis basin be kept out of sight? ______out of sight out of mine i. 6-8 small, dry feedings followed by _________clear liquids___ ________________ j. Foods/liquids should be _________icey cold___ or _____steamy hot__ k. Well-ventilated room

Question 29

Preeclampsia: 1. Definition: a. Increased BP, proteinuria, edema after ________week b. If Mom’s pre-pregnant baseline BP is not known then ________considered to be mild preeclampsia

Answer 29

Preeclampsia: 1. Definition: a. Increased BP, proteinuria, edema after ________20 week b. If Mom’s pre-pregnant baseline BP is not known then ________130/9_ is considered to be mild preeclampsia

Question 30

``` 5 S/S: preeclampsia a. Sudden _____________________ gain b. Face and hands swollen • Why? They are losing _________________, fluid doesn’t stay in vascular space, it leaks into the _________________. c. Headache,blurredvision,seeings pots d. Hyper-reflexia (increased DTRs) e. Clonus→Seizure ```

Answer 30

2. S/S: a. Sudden ____________weight_ gain b. Face and hands swollen Why? They are losing ________________protien( albumin)_, fluid doesn’t stay in vascular space, it leaks into the __________tissues_. c. Headache, blurred vision, seeing spots d. Hyper-reflexia (increased DTRs) e. Clonus→ Seizure- Vasospasms ( keyword for PIH) When you see a client that gains 2 or more pounds in a week watch closely and worry about PIH, For PIH check BP and the urine for protein

Question 31

When you see a client that gains 2 or more pounds in a week watch closely and worry about ____?

Answer 31

When you see a client that gains 2 or more pounds in a week watch closely and worry about PIH

Question 32

Preeclampsia mild tx Tx: a. Mild • BP _____ off their baseline documented 6 hours apart. • Mild: __________ as much as possible. • Increase what in their diet? _______________________ • They have glomerular damage with proteinuria.

Answer 32

a. Mild BP 30/15 off their baseline documented 6 hours apart. Mild: _____bedrest_ as much as possible. Increase what in their diet? ______________protein_ They have glomerular damage with proteinuria

Question 33

Severe tx for Preeclampsia BP elevated _______ documented _______hours apart. Sedation to delay ___________________________ __________ is the drug of choice

Answer 33

b. Severe: BP elevated 160/110 documented 6 hours apart. Sedation to delay ________seizures__ Magnesium Sulfate is the drug of choice

Question 34

MagnesiumSulfate:anticonvulsant,sedative,vasodilators MagnesiumSulfate:anticonvulsant,sedative,vasodilator 1) Vasodilation will increase _____________ ___________ and helps avoid renal failure and increases placental perfusion. 2) Positioning: NEVER lay a pregnant lady on her back, because this will place pressure on the vena cava→ impair kidney perfusion→ impair cardiac output→ impair kidney perfusion→ impair placenta perfusion. • Always place pregnant lady on her ____________. (preferably left side) 3) Magnesium sulfate is a simple salt solution (hypertonic) → fluid is attracted back into the vascular space and out of the tissues→ kidneys will diuresis→ if kidney function is impaired, or shift occurs too fast→ the client is at high risk for __________ ___________. 4) Nursing action for client receiving Magnesium: • When Magnesium Sulfate is used, checks for magnesium toxicity should be done q ______________. • These include: BP, respirations, DTRs, & LOC. • _____________________ is monitored hourly & serum magnesium is checked periodically. • If Magnesium Sulfate is used labor will stop unless augmented with Oxytocin (Pitocin®) We use magnesium for __________ labor. d. If diastolic > 100→ Apresoline (Hydralazine®) in combination with magnesium sulfate. • Side effects: ______________________ e. Only cure? ____________________ f. After delivery, the client is at risk for seizures for 48 hours.

Answer 34

Magnesium Sulfate: anticonvulsant, sedative, vasodilator 1) Vasodilation will increase _____renal perfusion___ and helps avoid renal failure and increases placental perfusion. 2) Positioning: NEVER lay a pregnant lady on her back, because this will place pressure on the vena cava ( because the full uterus will rise to the upper abdominal cavity and put pressure on the vena cava)→ perfusion→ impair cardiac output→ impair kidney perfusion→ impair placenta perfusion. Always place pregnant lady on her ___side_. (preferably left side) 3) Magnesium sulfate is a simple salt solution (hypertonic) → fluid is attracted back into the vascular space and out of the tissues→ kidneys will diuresis→ but if kidney function is impaired, or shift occurs too fast→ the client is at high risk for ___pulmonary enema. 4) Nursing action for client receiving Magnesium: When Magnesium Sulfate is used, checks for magnesium toxicity should be done q ___1-2 hrs__. These include: BP, respirations, DTRs ( this is the first to go if the pt is toxic on mg), and LOC. _____________ urinary output___ is monitored hourly ( because this how we excrete Mg) and serum magnesium is checked periodically ( usually abt every 8ht is typical) If Magnesium Sulfate is used labor will stop unless augmented with Oxytocin (Pitocin®) We use magnesium for _________preterm_ labor. Because it causes the uterus to relax d. If diastolic > 100→ Apresoline (Hydralazine®) in combination with magnesium sulfate. Side effects: ____ tachycardia_ e. Only cure? _________________delivery___ f. After delivery, the client is at risk for seizures for 48 hour

Question 35

Nursing Care: a. Single room b. Very quiet environment c. Dim the lights, no TV To do what ????

Answer 35

decreasing ____stimuli

Question 36

Preterm delivery=_______. Additional treatment is steroid therapy for Preeclampsia Given to patient that are high risk for preterm delivery • Betamethasone (Celestone®) stimulates _____________ production in the alveolar spaces and this causes less tension when the infant breathes. • Steroid therapy given between ____________ & _________ gestation to reduce infant mortality. • Expectant management: Balance the risk to mom vs. baby

Answer 36

Preterm delivery→ Immature lungs at birth. d. Additional treatment is steroid therapy: Betamethasone (Celestone®) stimulates _____ surfactant production in the alveolar spaces and this causes less tension when the infant breathes. Steroid therapy given between ___24__ &____34__ gestation to reduce infant mortality. Expectant management: Balance the risk to mom vs. baby

Question 37

Vasoconstriction→ lack of

Answer 37

Vasoconstriction→ lack of blood flow to placenta→ leads to less oxygen and nutrients to fetus→ Preterm delivery→ Immature lungs at birth.

Question 38

Eclampsia: | • What is the turning point from preeclampsia to eclampsia?

Answer 38

Eclampsia: | What is the turning point from preeclampsia to eclampsia? When they have a seizure

Question 39

``` Tx: elcampsia • Monitor the FHTs • Watch ____________________ • Watch for __________________ failure • Monitor for: heart failure, stroke, heart attack, renal failure, DIC, HELLP syndrome, neurological damage, multisystem organ failure ```

Answer 39

Tx: Monitor the FHTs Watch _______labor Watch for __________heart failure Monitor for: heart failure, stroke, heart attack, renal failure, DIC, HELLP syndrome, neurological damage, multisystem organ failure

Question 40

Premature Labor: 1. Definition: • Labor that occurs between ___________ weeks

Answer 40

J. Premature Labor: 1. Definition: Labor that occurs between ____20 & 37__ weeks

Question 41

``` Premature labor a. Drug therapy to stop the labor: 1) Tocolytic: Terbutaline (Brethine) • Side effects of Brethine? _______________ ______________ & hyperactivity. 2) Mg Sulfate ``` 3) Betamethasone (Celestone®) • Given IM to mom • The purpose is to stimulate maturation of the baby’s lungs in case preterm birth occurs. 4)b. Preterm labor can sometimes be stopped by _________________ Mom and by treating vaginal and urinary tract _________________.

Answer 41

1) Tocolytic: Terbutaline (Brethine) Side effects of Brethine? _______increase pulse__ ______________ & hyperactivity. 2) Mg Sulfate 3) Betamethasone (Celestone®) Given IM to mom The purpose is to stimulate maturation of the baby’s lungs in case preterm birth occurs. b. Preterm labor can sometimes be stopped by ______ hydrating__ Mom and by treating vaginal and urinary tract ________infections.

Question 42

Prolapsed Cord: 1. Definition: a. When the umbilical cord falls down through _____________________ b. Most likely to happen when presenting part is not engaged and membranes _____________________________

Answer 42

Prolapsed Cord: 1. Definition: a. When the umbilical cord falls down through _________cervix b. Most likely to happen when presenting part is not engaged and membranes ___________________Ruptures___

Question 43

Nursing Actions: prolapsed cord a. Important to check __________when membranes rupture either spontaneously or artificially. b. If cord is being compressed you would see variable deceleration in FHT, so an immediate _______________________ is indicated. Warning: c. If cord ceases to pulsate→ fetal _________________ has occurred; • We want the cord to pulsate because this tells us baby is getting some oxygen

Answer 43

2. Nursing Actions: a. Important to check ___fetal heart tones___when membranes rupture either spontaneously or artificially. b. If cord is being compressed you would see variable deceleration in FHT, so an immediate _____c section is indicated. Warning: c. If cord ceases to pulsate→ fetal ______death____ has occurred; We want the cord to pulsate because this tells us baby is getting some oxygen

Question 44

. Tx: Prolapsed cord a. Lift head off cord until physician arrives if possible • This is a manual lift, the nurse pushes the head up to relieve pressure on the ___________________. b. Trendelenburg or ______________ chest position c. AdministerOxygen d. Monitor fetal heart tones. e. Pushitbackin?____________

Answer 44

3. Tx: a. Lift head off cord until physician arrives if possible This is a manual lift, the nurse pushes the head up to relieve pressure on the ________cord__. b. Trendelenburg or _____knee __ chest position c. Administer Oxygen d. Monitor fetal heart tones. e. Push it back in? _____no___

Question 45

Shoulder Dystocia: 1. Definition: a. Fetal head is delivered and further delivery of the fetus is prevented by the impaction of the fetal ___________ with the maternal __________. b. Anterior shoulder of fetus becomes impacted by the symphysis pubis.

Answer 45

L. Shoulder Dystocia: 1. Definition: a. Fetal head is delivered and further delivery of the fetus is prevented by the impaction of the fetal ___shoulder__ with the maternal _____pelvis__. b. Anterior shoulder of fetus becomes impacted by the symphysis pubis.

Question 46

2. Risk to Fetus: shoulder dystocia a. Hypoxia→ leads to cerebral palsy and asphyxia b. Brachial plexus injury- leading to Erb’s Palsy (drooping/ paralysis of an arm caused by excessive traction and stretching of the brachial nerve at delivery) c. Broken __________________ d. Bell’s palsy is paralysis of face with drooping of one side of the face. e. Causedfrom___________________ f. Many resolve, but can lead to permanent damage.

Answer 46

2. Risk to Fetus: a. Hypoxia→ leads to cerebral palsy and asphyxia from cord compression b. Brachial plexus injury- leading to Erb’s Palsy (drooping/ paralysis of an arm caused by excessive traction and stretching of the brachial nerve at delivery) c. Broken __ clavicle d. Bell’s palsy is paralysis of face with drooping of one side of the face. e. Caused from _________ forceps____ f. Many resolve, but can lead to permanent damage.

Question 47

Maternal Risk: Shoulder Dystocia a. Traumatic delivery leading to permanent damage. b. Bruised bladder. c. Extension of episiotomy d. Rectal tear e. Torn cervix and/oruterus

Answer 47

3. Maternal Risk: a. Traumatic delivery leading to permanent damage. b. Bruised bladder. c. Extension of episiotomy d. Rectal tear e. Torn cervix and/or uterus

Question 48

Who’s at risk: Shoulder Dystocia a. LGA or macrosomic infants >4000 grams b. Gestational diabetes c. Previoushistoryofshoulderdystocia d. Post date delivery→ large fetus

Answer 48

4. Who’s at risk: a. LGA or macrosomic infants >4000 grams b. Gestational diabetes c. Previous history of shoulder dystocia d. Post date delivery→ large fetus

Question 49

``` Nursing Care: Shoulder Dystocia a. ______________ Maneuvers b. Mazzanti techniques • Never apply _____________ ________________. The physician must do this or call another physician. ```

Answer 49

``` Nursing Care: a. _____________ make Robert_ Maneuvers b. Mazzanti techniques Never apply ____ fondu pressure ________________. The physician must do this or call another physician. ```

Question 50

Group B Streptococcus (GBS) 1. Leading cause of neonatal morbidity. 2. Routinely assess for GBS risk factors during pregnancy (cultured around 35-37 weeks) and on admission to L & D. 3. Transmitted to infant from birth canal of the infected mother during delivery. 4. Risk for fetus is only after rupture of membranes. 5. Teaching: client needs to understand it is not a sexually transmitted disease (STD). 6. Risk factors for neonatal GBS: Preterm birth less than 37 weeks, + prenatal cultures in current pregnancy, premature rupture of membranes (longer than 18hr), positive history for early-onset neonatal GBS, intrapartum maternal fever higher than 100.4o F, previous infant with GBS.

Answer 50

Group B Streptococcus (GBS) 1. Leading cause of neonatal morbidity. 2. Routinely assess for GBS risk factors during pregnancy (cultured around 35-37 weeks) and on admission to L & D. 3. Transmitted to infant from birth canal of the infected mother during delivery. 4. Risk for fetus is only after rupture of membranes. 5. Teaching: client needs to understand it is not a sexually transmitted disease (STD). 6. Risk factors for neonatal GBS: Preterm birth less than 37 weeks, + prenatal cultures in current pregnancy, premature rupture of membranes (longer than 18hr), positive history for early-onset neonatal GBS, intrapartum maternal fever higher than 100.4º F, previous infant with GBS.

Question 51

Tx: Group B Streptococcus (GBS) | • Prophylactic antibiotic therapy, Penicillin is drug of choice.

Answer 51

Tx: | • Prophylactic antibiotic therapy, Penicillin is drug of choice.

Question 52

Magnesium sulfate is a ____ ___ ____ (_______) → fluid is attracted back into the ___ space and out of the _____→ kidneys will diuresis→ if kidney function is impaired, or shift occurs too fast→ the client is at high risk for ___

Answer 52

Magnesium sulfate is a simple salt solution (hypertonic) → fluid is attracted back into the vascular space and out of the tissues→ kidneys will diuresis→ if kidney function is impaired, or shift occurs too fast→ the client is at high risk for ___