Exam #1 Flashcards
Gravidity
Pregnancy
Parity
The number of pregnancies in which the fetus or fetuses have reached 20 weeks of gestation, not the number of fetuses born. The numeric designation is not affected by whether the fetus is born alive or is stillborn.
Quickening
Fetal movements first felt by the pregnant woman at 16 to 18 weeks of gestation.
Chronic Hypertension
Hypertension present before pregnancy or diagnosed before 20 weeks of gestation
Eclampsia
Onset of seizure activity or coma in the woman diagnosed with preeclampsia, with no history of preexisting pathology that can result in seizure activity.
Gestational Hypertension
Onset of hypertension during pregnancy or in the first 24 hours after birth without other signs or symptoms of preeclampsia and without preexisting hypertension.
HELLP Syndrome
Laboratory diagnosis for a variant of severe preeclampsia that involves hepatic dysfunction; it is characterized by hemolysis, elevated liver enzymes, and low platelets.
Preeclampsia
Pregnancy-specific syndrome in which hypertension develops after 20 weeks of gestation in a previously normotensive woman. It is a multisystem, vasospastic disease process of reduced organ perfusion characterized by the presence of hypertension and proteinuria with a clinical continuum from mild to severe.
Anemia
A hemoglobin level of less than 11g/dL or a hematocrit of less than 33% in the pregnant woman; it is mainly a result of an iron deficiency
Maternal Serum Alpha-Fetoprotein (MSAFP)
Test used as a screening tool for neural tube defects in pregnancy. The test is usually performed between 16 and 18 weeks of gestation.
Triple Marker
Test used to screen for Down Syndrome. It is performed between 16 and 18 weeks of gestation. The levels of three markers, namely MSAFP, unconjugated estriol, and hCG, in combination with maternal age are used to determine risk.
Nonstress Test (NST)
Test based on the fact that the heart rate of a healthy fetus with an intact central nervous system will usually accelerate in response to its own movement.
Risk factors for Preterm Labor
Age younger than 16 or older than 35 years, Low socioeconomic status, Maternal weight below 50 kg (110 lb), Poor nutrition, Previous preterm birth, Incompetent cervix, Uterine anomalies, Smoking, Drug addition and alcohol abuse, Pyelonephritis, Pneumonia, Multiple gestation, Anemia, Abnormal fetal presentation, Preterm rupture of membranes, Placental abnormalities, Infection
Risk factors for Polyhydraminos
Diabetes mellitus, Multiple gestation, Fetal congenital abnormalities, Isoimmunization (Rh or ABO), Nonimmune hydrops, Abnormal fetal presentation
Intrauterine Growth Restriction
Multiple gestation, Poor nutrition, Maternal cyanotic heart disease, Prior pregnancy with intrauterine growth restriction, Maternal collagen diseases, Chronic hypertension, Gestational hypertension, Recurrent antepartum hemorrhage, Smoking, Maternal diabetes with vascular problems, Fetal infections, Fetal cardiovascular anomalies, Drug addiction and alcohol abuse, Fetal congenital anomalies, Hemoglobinopathies
Risk factors for Oligohydraminos
Renal agenesis (Potter’s syndrome), Prolonged rupture of membranes, Intrauterine growth restriction, Intrauterine fetal death
Risk factors for Postterm Pregnancy
Anencephaly, Placental sulfatase deficiency, Perinatal hypoxia/acidosis, Placental insufficiency
Risk factors for Chromosome Abnormalities
Maternal age 35 years or older at birth, Balanced translocation (maternal and paternal)
What are some s/s of severe preeclampsia?
Systolic BP > 160mm Hg; Diastolic BP of at least 110mm Hg; Proteinuria of 5g or more per 24hr speciman; Oliguria; Cerebral disturbances: altered LOC, confusion, or HA; Visual disturbances: scotomata or blurred vision; Hepatic involement: epigastric pain, RUQ pain, impaired liver fxn or elevated liver enzymes; Thrombocytopenia with a platelet count < 100,000mm3; Hemolytic anemia; Pulmonary edema; Fetal growth restriction
Nursing diagnoses for severe preeclampsia.
Risk for injury to mother and fetus r/t CNS irritability; Ineffective tissue perfusion r/t to preeclampsia secondary to arteriolar vasospasm; Risk for excess fluid volume r/t increased sodium retention secondary to admin of magnesium sulfate; Risk for impaired gas exchange r/t pulmonary edema secondary to increased vascular resistance; Risk for decreased cardiac output r/t use of antihypertensive drugs; Risk for injury to fetus r/t uteroplacental insufficiency secondary to use of antihypertensive medications
What are some precautionary measure that should be taken for severe preeclampsia?
Environment: quiet, nonstimulating, lighting subdued; Seizure precautions: suction equipment tested and ready to use, oxygen admin equipment tested and ready to use; Call button within easy reach; Emergency medication tray immediately accessible: Hydralazine or other antihypertensive medication and magnesium sulfate immediately available, calcium gluconate immediately available; Emergency birth pack accessible
What is the drug of choice in the prevention and treatment of convulsions caused by preeclampsia or eclampsia?
Magnesium Sulfate
Is magnesium sulfate infused using a main IV line or as a secondary infusion (“piggyback”)?
It is admin as a secondary infusion (“piggyback”) to the main IV line by volumetric infusion pump.
How is the initial loading dose of magnesium sulfate administered?
An initial loading dose of 4-6g diluted in at least 100mL of IV fluid per protocol or physician’s order is infused over 15-30 minutes.
