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Maternity Child Nursing > Complications of Pregnancy > Flashcards

Complications of Pregnancy Flashcards

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1
Q

early hemorrhagic conditions most common in 1st half of pregnancy

A

abortion
ectopic pregnancy
hydatidiform mole

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2
Q

1 cause of maternal death

A

ectopic pregnancy

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3
Q

spontaneous abortion

A

-loss of pregnancy before viability (20 wks)

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4
Q

what is the leading cause of pregnancy loss and why

A

spontaneous abortion

  • chances increase with advanced maternal age
  • occurs in first 12 wks
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5
Q

reasons spontaneous abortion occurs

A
  • severe congential anomalies (body will abort it)
  • maternal infections/endocrine disorders/STIs
  • immunologic (lupus)
  • uterine or cervical defects
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6
Q

threatened abortion

A

abortion that may not happen but there is a risk

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7
Q

s/s of a threatened abortion

A
  • vaginal bleeding
  • cramps
  • backache
  • pelvic pressure
  • increased B-hCG levels
  • increased uterine size
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8
Q

inevitable abortion

A

an abortion that will happen

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9
Q

s/s of an inevitable abortion

A
  • ruptured membrane
  • cervical dilatation
  • heavy bleeding
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10
Q

management of an inevitable abortion

A
  • natural expulsion (baby will pass on their own)

- dilatation & vacuum curettage (D&C)

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11
Q

D&C

A
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12
Q

s/s of incomplete D&C

A
  • cramping

- bleeding

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13
Q

incomplete abortion

A

partially retained products of conception

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14
Q

s/s of an incomplete abortion

A
  • active bleeding

- severe abd cramping

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15
Q

management of incomplete abortion

A
  • before 14 weeks: CV stabilization -> curettage -> uterotonic drugs
  • after 14 weeks: oxytocin or prostaglandin
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16
Q

complete abortion

A

all products of conception are expelled from the uterus

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17
Q

management of complete abortion

A

no intervention needed unless there is excessive bleeding and infection

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18
Q

pt teaching with complete abortion

A
  • report bleeding, pain, or fever

- abstain from intercourse for 3months

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19
Q

missed abortion

A

fetus dies in the 1st half of pregnancy

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20
Q

s/s of missed abortion

A
  • early s/s of pregnancy disappear

- uterine growth halts and reduces in size

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21
Q

management of missed abortion in 1st trimester

A

D&C

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22
Q

management of missed abortion in 2nd trimester

A

prostaglandins (to give birth)

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23
Q

recurrent spontaneous abortion

A

3+ consecutive spontaneous abortions

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24
Q

reasons for recurrent spontaneous abortions

A
  • genetic/chromosomal abnormalities (mom&dad may not be compatible with each other)
  • reproductive tract anomalies
  • hormones/immunologic factors
  • systemic diseases
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25
Q

tx of recurrent spontaneous abortions

A
  • antimicrobials
  • hormone-related medications
  • cerclage
  • reproductive exam
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26
Q

nursing responsibilities for abortion

A
  • hypovolemic shock
  • IVF and blood products
  • monitor VS & UO
  • grief and loss
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27
Q

ectopic pregnancy

A

implantation outside of the uterus

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28
Q

risk factors for ectopic pregnancy

A
  • decreased cilia
  • fallopian tube scarring
  • pelvic inflammation
  • previous surgery
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29
Q

ectopic pregnancy at the distal end of the fallopian tube

A
  • missed menses
  • intermittent abd and pelvic pain
  • vaginal spotting
  • embryo may have been absorbed by body
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30
Q

ectopic pregnancy at the proximal end of the fallopian tube

A

rupture w/in 2-3 wks of missed period

  • sudden severe pain BLQ
  • intraabd hemorrhage
  • Kehr’s sign (shooting, stabbing pain in shoulder)
  • hypovolemic shock
31
Q

how to diagnose an ectopic pregnancy

A
  • transvaginal US

- B-hCG

32
Q

nursing responsibilities for ectopic pregnancy

A
  • prevent hypovolemic shock
  • pain mgmt
  • psychological support
  • report s/s
  • no alcohol or PNV with folic acid
33
Q

hydatidiform mole

A

globular pregnancy - a blob with teeth, hair, etc

  • trophoblasts develop abnormally
  • placenta development, but no fetal development
34
Q

complete hydatidiform mole

A

without fetus

35
Q

partial hydatidiform mole

A

with fetal tissue

36
Q

a hydatidiform mole is threatening if

A

it is malignant or an embolus

37
Q

how to diagnose a hydatidiform mole

A
  • US

- high B-hCG (super duper high)

38
Q

s/s of hydatidiform mole

A
  • vaginal bleeding
  • large uterus
  • excessive n/v
39
Q

tx of hydatidiform mole

A
  • chest imaging and labs
  • # 1 concern is vacuum aspiration
  • F/U for malignant changes
  • chemo if it is malignant
  • wait 1 yr to get pregnant again
40
Q

bleeding during the 1st trimester

A

may result from a spontaneous abortion (miscarriage)

41
Q

bleeding during the 2nd & 3rd trimester

A

may indicate an abnormal location of the placenta

42
Q

late hemorrhagic conditions

A

after 20 wks

  • placenta previa
  • abruptio placentae
43
Q

placenta previa

A

placenta is covering the cervical os (vaginal opening)

44
Q

3 types of placenta previa

A
  1. marginal
  2. partial
  3. total
45
Q

s/s of placenta previa

A

sudden onset painless bleeding d/t villi torn from uterine wall

46
Q

management of placenta previa

A
  • cardiovascular stability
  • FHT pattern
  • delay birth/fetal lung maturity
47
Q

abruptio placentae

A

placental seperation before birth

-hematoma on maternal side of placenta

48
Q

s/s of abruptio placentae

A
  • vaginal bleeding vs concealed
  • abd and low back pain
  • high resting tone
  • uterine tenderness
49
Q

management of abruptio placentae

A
  • cardiovascular stability
  • FHTs
  • RhoGAM
50
Q

DIC

A

anticoagulation & procoagulation

  • missed abortion
  • abruptio placentae
  • HTN
51
Q

diagnosing DIC

A
  • decreased fibrinogen and platelets
  • prolonged PT/PTT
  • +D dimer
52
Q

mgmt of DIC

A
  • delivery of fetus and placenta stops thromboplastin

- blood products

53
Q

hyperemesis gravidarum

A

persistent uncontrollable vomiting

  • 5% loss of prepregnancy weight
  • risk for low birth weight
  • highest incidence in single white female
54
Q

tx of hyperemesis gravidarum

A
  • prevent dehydration, malnutrition, F/E imbalance
  • I&Os, labs, IVF/TPN, daily wts
  • meds
55
Q

gestational HTN

A
  • BP>140/90 after 20 wks IUP
  • if not WNL by 6 wks postpartum, chronic HTN
  • no proteinuria
56
Q

preeclampsia

A

generalized vasospasm

-decreased circulation to kidneys, liver, brain, & placenta

57
Q

s/s of preeclampsia

A
  • HTN
  • proteinuria
  • hyperreflexia
  • HA
  • drowsiness
58
Q

goal of preeclampsia tx

A

increase placental blood flow and prevent injury of the baby

59
Q

tx of severe preeclampsia

A
  • <34 wks: steroids and delay vaginal birth for 48 hrs
  • bedrest/calm environment and FHTs
  • anticonvulsants & antiHTN
  • monitor BUN, Cr, Uric acid, Mag, LFTs
60
Q

eclampsia

A
  • onset of 1+ seizures
  • pregnancy, intrapartum, or postpartum
  • fluid shift causes hypovolemia
61
Q

mgmt of eclampsia

A
  • breath sounds, O2, UO
  • Lasix & Digitalis rid excess fluid and reduce the pressure in heart
  • monitor ROM, FHT, UC, and abruption
62
Q

HELLP syndrome

A

life threatening complication of severe HTN

  • hemolysis
  • increased liver enzymes
  • low platelets
63
Q

s/s of HELLP

A
  • pain: RUQ, lower chest, or epigastric
  • tenderness d/t liver distention
  • n/v and sever edema
64
Q

tx of HELLP

A

same as preeclampsia/eclampsia

65
Q

chronic HTN

A

HTN that occurs prepregnancy or <20 wks

-high risk for preeclampsia development

66
Q

tx for chronic HTN

A
  • high protein diet
  • frequent BPP and kick counts
  • methyldopa if DBP > 100 consistently
  • hydralazine if HTN crisis
67
Q

maternal effects of gestational DM

A
  • preeclampsia
  • UTI
  • hydramnios
  • shoulder dystocia
68
Q

fetal effects of gestational DM

A
  • congenital malformation
  • IUGR
  • macrosomic
69
Q

neonatal effects of gestational DM

A
  • hypoglycemia
  • hypocalcemia
  • hyerbilirubinemia
  • respiratory distress syndrome
70
Q

cardiac disease

A

CV changes can cause cardiac decompensation

71
Q

goal of cardiac disease

A

CHF prevention

  • restrict activity
  • limit weight gain
  • prevent anemia and infection
72
Q

toxoplasmosis

A
  • protozoal infection
  • mother may be infected by improper handling of cat litter or handling/ingesting contaminated meat
  • fetus may contract through the placental connection
73
Q

s/s of toxoplasmosis

A
  • fatigue
  • muscle aches
  • swollen glands

Maternity Child Nursing (5 decks)

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