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Maternity Child Nursing > Complications of Pregnancy > Flashcards

Complications of Pregnancy Flashcards

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
tx of recurrent spontaneous abortions
- antimicrobials - hormone-related medications - cerclage - reproductive exam
26
nursing responsibilities for abortion
- hypovolemic shock - IVF and blood products - monitor VS & UO - grief and loss
27
ectopic pregnancy
implantation outside of the uterus
28
risk factors for ectopic pregnancy
- decreased cilia - fallopian tube scarring - pelvic inflammation - previous surgery
29
ectopic pregnancy at the distal end of the fallopian tube
- missed menses - intermittent abd and pelvic pain - vaginal spotting - embryo may have been absorbed by body
30
ectopic pregnancy at the proximal end of the fallopian tube
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
how to diagnose an ectopic pregnancy
- transvaginal US | - B-hCG
32
nursing responsibilities for ectopic pregnancy
- prevent hypovolemic shock - pain mgmt - psychological support - report s/s - no alcohol or PNV with folic acid
33
hydatidiform mole
globular pregnancy - a blob with teeth, hair, etc - trophoblasts develop abnormally - placenta development, but no fetal development
34
complete hydatidiform mole
without fetus
35
partial hydatidiform mole
with fetal tissue
36
a hydatidiform mole is threatening if
it is malignant or an embolus
37
how to diagnose a hydatidiform mole
- US | - high B-hCG (super duper high)
38
s/s of hydatidiform mole
- vaginal bleeding - large uterus - excessive n/v
39
tx of hydatidiform mole
- 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
bleeding during the 1st trimester
may result from a spontaneous abortion (miscarriage)
41
bleeding during the 2nd & 3rd trimester
may indicate an abnormal location of the placenta
42
late hemorrhagic conditions
after 20 wks - placenta previa - abruptio placentae
43
placenta previa
placenta is covering the cervical os (vaginal opening)
44
3 types of placenta previa
1. marginal 2. partial 3. total
45
s/s of placenta previa
sudden onset painless bleeding d/t villi torn from uterine wall
46
management of placenta previa
- cardiovascular stability - FHT pattern - delay birth/fetal lung maturity
47
abruptio placentae
placental seperation before birth | -hematoma on maternal side of placenta
48
s/s of abruptio placentae
- vaginal bleeding vs concealed - abd and low back pain - high resting tone - uterine tenderness
49
management of abruptio placentae
- cardiovascular stability - FHTs - RhoGAM
50
DIC
anticoagulation & procoagulation - missed abortion - abruptio placentae - HTN
51
diagnosing DIC
- decreased fibrinogen and platelets - prolonged PT/PTT - +D dimer
52
mgmt of DIC
- delivery of fetus and placenta stops thromboplastin | - blood products
53
hyperemesis gravidarum
persistent uncontrollable vomiting - 5% loss of prepregnancy weight - risk for low birth weight - highest incidence in single white female
54
tx of hyperemesis gravidarum
- prevent dehydration, malnutrition, F/E imbalance - I&Os, labs, IVF/TPN, daily wts - meds
55
gestational HTN
- BP>140/90 after 20 wks IUP - if not WNL by 6 wks postpartum, chronic HTN - no proteinuria
56
preeclampsia
generalized vasospasm | -decreased circulation to kidneys, liver, brain, & placenta
57
s/s of preeclampsia
- HTN - proteinuria - hyperreflexia - HA - drowsiness
58
goal of preeclampsia tx
increase placental blood flow and prevent injury of the baby
59
tx of severe preeclampsia
- <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
eclampsia
- onset of 1+ seizures - pregnancy, intrapartum, or postpartum - fluid shift causes hypovolemia
61
mgmt of eclampsia
- breath sounds, O2, UO - Lasix & Digitalis rid excess fluid and reduce the pressure in heart - monitor ROM, FHT, UC, and abruption
62
HELLP syndrome
life threatening complication of severe HTN - hemolysis - increased liver enzymes - low platelets
63
s/s of HELLP
- pain: RUQ, lower chest, or epigastric - tenderness d/t liver distention - n/v and sever edema
64
tx of HELLP
same as preeclampsia/eclampsia
65
chronic HTN
HTN that occurs prepregnancy or <20 wks | -high risk for preeclampsia development
66
tx for chronic HTN
- high protein diet - frequent BPP and kick counts - methyldopa if DBP > 100 consistently - hydralazine if HTN crisis
67
maternal effects of gestational DM
- preeclampsia - UTI - hydramnios - shoulder dystocia
68
fetal effects of gestational DM
- congenital malformation - IUGR - macrosomic
69
neonatal effects of gestational DM
- hypoglycemia - hypocalcemia - hyerbilirubinemia - respiratory distress syndrome
70
cardiac disease
CV changes can cause cardiac decompensation
71
goal of cardiac disease
CHF prevention - restrict activity - limit weight gain - prevent anemia and infection
72
toxoplasmosis
- 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
s/s of toxoplasmosis
- fatigue - muscle aches - swollen glands

Maternity Child Nursing (5 decks)

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