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Women's Health > Exam 1 Test Map 3 > Flashcards

Exam 1 Test Map 3 Flashcards

1
Q

cervix is dilated so INEVITABLE that the contents will come out of the uterus; rupture of membranes (ROM), & passage of products of conception occurs

A

inevitable miscarriage

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2
Q

expulsion of the fetus with retention of the placenta; retained products of conception (POC); fetus came out, but products of placenta were retained so HUGE risk of bleeding & INFECTION

A

incomplete miscarriage

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3
Q

no POC retained cervix has already closed after all the fetal tissue was expelled; slight bleeding may occur & milk uterine cramps; NOTHING left inside

A

complete miscarriage

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4
Q

a pregnancy in which the fetus has died but the products of conception are retained in utero for up to several weeks; fetus died, but not expelled

A

missed miscarriage

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5
Q

When the door of the uterus is OPEN (the door of the uterus is the cervix)…

A

there is NOTHING to hold the contents of the uterus IN! So, the CERVIX holds in the contents of the uterus!

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6
Q

termination of pregnancy before 20 weeks; fetus is <500 grams

A

abortion

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7
Q

types of abortions

A

Abortion can be elective (social/therapeutic reasons) or Spontaneous (natural causes)

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8
Q

a pregnancy that ends as a result of natural causes before 20 weeks of gestation

A

Miscarriage (spontaneous abortion

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9
Q

3 or more spontaneous pregnancy losses before 20 weeks successively

A

Habitual/Recurrent

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10
Q

the cervix will open for no reason & this can cause habitual abortion so we can put a suture around the cervix to help it not open

A

cervical incompetence (aka cervical insufficiency)

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11
Q

infection

A

septic

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12
Q

: A benign degenerative process of the placenta; the chorionic villi degenerate into edematous, cystic, avascular, transparent vesicles that hang in grape-like clusters; the chromosomes were incorrect to make a baby-there were some components of DNA that met, but there was no baby; placenta grows & overgrows!

A

molar pregnancy

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13
Q

Looks like hanging grapes in clusters on sonogram-NO fetus!! COUNTED AS A PREGNANCY (gravida), but not a Parity because it will not make it to 20 weeks; considered an A in GTPAL! Ultrasound helps diagnose this!

A

molar pregnancy

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14
Q

fertilization of the egg with NO nucleus/DNA; the sperm nucleus duplicates itself; “Mole” grows rapidly! The vesicles that form in the uterus can rupture the uterus or come out of the vagina. At 20 weeks the uterus should be in the umbilicus & at 20 weeks with a Molar Pregnancy-the SIZE is MUCH GREATER than the DATE (10-12 weeks pregnant, but uterus is up in the umbilicus)

A

complete molar pregnancy

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15
Q

S/S of molar pregnancy

A

Abnormal uterine bleeding, uterus larger than dates, anemia from blood loss (mom show signs of anemia: light-headedness, etc.), excessive vomiting (HCG levels go extremely high because the placenta is developing so fast),, abdominal cramps (because uterus is growing so fast), preeclampsia (HTN) before 20 weeks, No Fetal Heart Tones or Fetal Skeleton, Increased HCG Levels

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16
Q

Careful follow up after Molar Pregnancy

A

often need prophylactic chemotherapy (because of the HIGH RISK FOR CHORIOCARCINOMA)-give Methotrexate as part of chemo regimen

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17
Q

where the fertilized ovum is implanted somewhere other than in the uterine cavity (can be in the tube, abdominal, cervical, ovarian regions) but the ONLY place capable of growing/developing the fetus is the BODY OF THE UTERUS! Therefore will NOT go to term.

A

ectopic pregnancy

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18
Q

Abortion, Ectopic Pregnancy, & Molar Pregnancy all lead to

A

lead to pregnancy loss-SUPPORT & COUNSEL-let them know you are there for them if there is anything they need and use therapeutic communication

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19
Q

S/S of ectopic pregnancy

A

MOST COMMON COMPLAINT-unilateral (one-sided), sharp abdominal or pelvic pain and it is very early in pregnancy (1st trimester)

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20
Q

why are ectopic pregnancies a MAJOR issue

A

the tube may rupture and lead to massive hemorrhaging which can lead to SHOCK!

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21
Q

where the placenta is malpositioned and attached in the lower uterine segment rather than the fundus (want the placenta HIGH in the fundus)

A

placenta previa

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22
Q

anytime there is Placenta Previa we must deliver…

A

by C-Section (because you cannot deliver the placenta before the baby or the baby will have no oxygen)! This can cause MASSIVE BLEEDING;

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23
Q

what can placenta previa lead to

A

to shock for mom & lack of oxygen for baby!

24
Q

where the placenta barely covers the cervical os (when the cervix starts to dilate & open this will cause abruption)

A

marginal placenta

25
Q

placenta partially covers the cervical os (cervical opening)

A

partial placenta

26
Q

placenta completely covers the cervical os (cervical opening)

A

total placenta

27
Q

S/S of Placenta Previa

A

bright red vaginal bleeding that is PAINLESS & uterine tone is normal

28
Q

premature separation of the placenta before birth (when the placenta comes off the uterus wall); VERY URGENT-can cause loss of life to mom & baby; this is a Major Medical Emergency!

A

abruption placenta

29
Q

mom’s blood bleeding into uterus & baby’s blood bleeding into placenta; very small amounts of blood because it is a small tear which clotted off- “concealed”

A

Partial Separation/Concealed Hemorrhage

30
Q

no clotting and apparent vaginal bleeding; mom & baby at risk for massive hemorrhage! “Apparent” blood is coming out & placenta is torn partially off the wall

A

Partial Separation/Apparent Hemorrhage

31
Q

completely off the wall & may be apparent or concealed depending on how fast it happens; baby is getting NO oxygen since baby is hemorrhaging their blood out into the placenta and mom is hemorrhaging her blood out into the uterus

A

Complete Separation/Concealed or Apparent Hemorrhage

32
Q

S/S of Abruptio Placenta

A

RIGID, BOARD-LIKE ABDOMEN with PAINFUL uterine or abdominal tenderness
pain is so severe that if she has an epidural-the pain can break through the epidural; Uterine bleeding, Look for DECREASED fetal heart tones (if there is a loss of oxygen to the placenta through the gap we will see a DECREASE in fetal heart tones) & Palpate mom’s abdomen-if it is RIGID, BOARD-LIKE we think bleeding!

33
Q

3 assessments to look for with bleeding

A

1) where is the bleeding coming from
2) How much blood is coming out? (measured in peripad saturation)
3) changes in vitals?? (1- widened pulse pressure 2-elevated HR 3-decrease in BP)

34
Q

immediate interventions for bleeding

A

1) call for help
2) give O2 per 10 L non rebreather
3) start 1 or 2 large bore IV lines and hang fluid replacement
4) monitor for FHT and be ready for potential surgery (ie/ suction or ectopic)
5) monitor VITALS

35
Q

major responsibility of nurse during bleeding interventions

A

start 1 or 2 large bore IV lines and hang fluid replacement

36
Q

first step min screening for gestational diabetes

A

screen consisting of a 50-g oral glucose load followed by a plasma glucose measurement 1 hour later

37
Q

glucose level of what is considered a positive screen for gestational diabetes is followed by what

A

glucose value of 130-140 mg/dl

38
Q

a positive screen for gestational diabetes is followed by what

A

step 2-a 3-hour (100-g) oral glucose tolerance test (OGTT) on another day

39
Q

pregnancy-specific condition in which hypertension develops after 20 weeks of gestation in a woman who previously had neither condition

A

preeclampsia

40
Q

The signs and symptoms of preeclampsia also can develop for the first time when

A

during post partum period

41
Q

symptoms of preeclampsia

A

BP greater than 140/90 at least 4 hours apart after 20 weeks gestation in previously normative woman AND ONE OF THE FOLLOWING: Proteinuria greater than 300 mg in a 24-hour specimen, Thrombocytopenia which is a platelet count less than 100,000, Elevated liver enzymes, Serum Creatinine level of greater than 1.1 mg/dl significant of renal insufficiency, pulmonary edema, and new onset cerebral or visual disturbances

42
Q

Laboratory diagnosis for a variant of severe preeclampsia that involves hepatic dysfunction
NOT a separate illness

A

HELLP syndrome

43
Q

HELLP syndrome characterized by what

A

hemolysis (H), elevated liver enzymes (EL), and low platelet (LP) count.

44
Q

what is HELLP syndrome the result of

A

Result of arteriolar vasospasm, endothelial cell destruction with fibrin deposits, and adherence of platelets in blood vessels

45
Q

symptoms associated with HELLP

A

malaise, influenza like symptoms, epigastric or right upper quadrant pain, and symptoms that worsen overnight and improve during the day.

46
Q

also known as consumptive coagulopathy

A

Disseminated intravascular coagulation (DIC)

47
Q

pathologic form of clotting that is diffuse and consumes large amounts of clotting factors, causing widespread external bleeding, internal bleeding, or both and clotting
NEVER a primary diagnosis

A

DIC

48
Q

results from some event that triggered the clotting cascade, either extrinsically, by the release of large amounts of tissue thromboplastin, or intrinsically, by widespread damage to vascular integrity.

A

DIC

49
Q

If someone if floated to Labor and Delivery:

A 
1-you treat her like she is a brand new nurse with no experience
2-give her routine care/ a stable patient- that is delivered
3-Give the nurse a patient who is closely related to the unit she was floated from eg. ER nurse- give her the postpartum patient who is in pain because she works every day with patients in pain
4-She cannot interpret tests such as fetal monitoring tests which requires a class or unit specific teaching
50
Q

Understand and be able to assign an LPN in the Women’s Service Area:

A

They cannot do comprehensive physical assessments. Therefore, routine such as: baths, tasks (caths/ pericare and feeding babies would be appropriate.
They cannot educate because that requires an assessment of the understanding of the education of the pt. LPNs cannot EAT- EVALUATE, ASSESS, or TEACH!!!

51
Q

Prevention/ treatment of iron deficiency anemia

A

ferrous sulfate

52
Q

nursing interventions for ferrous sulfate

A

Advise patient that stools may turn dark green or black. Assess bowel function for constipation/ diarrhea. Monitor H+H every 3 weeks for first 2 months of therapy

53
Q

Prevention of seizures associated with severe eclampsia and pre-eclampsia

A

magnesium sulfate

54
Q

nursing interventions for magnesium sulfate

A

Avoid use for more than 5-7 days for preterm labor. Avoid continuous use during active labor or within 2 hours of delivery. Monitor Pulse, BP, resperations (at least 16 min before each dose). Initiate seizure precautions. Monitor I’s + O’s. Patellar reflex should be tested before each dose (if absent, hold dose).

55
Q

Antidote for Magnesium Sulfate. Treatment and Prevention of Hypocalcemia.

A

calcium gluconate

56
Q

nursing interventions for calcium gluconate

A

Observe patient closely for hypocalcemia (paresthesia, muscle twitching, laryngospasm, colic, cardiac arrhythmias, Chvostek’s or Trousseau’s sign). Do not take with milk, 1-2 hours within any other med.

Women's Health (31 decks)

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