Gestational Complications and Preterm labor

Question 1

abortion

Answer 1

a pregnancy that does not reach the point of viability (20 weeks gestation)

Question 2

symptoms of abortion

Answer 2

cervix dilates
vaginal bleeding
no bleeding (missed abortion)
cramping/backache
declining HCG levels
all products of pregnancy are expelled
fetal heart tones present (threatened only)

Question 3

management of abortion

Answer 3

D+C/ suction courttage for incomplete or missed abortion
monitor bleeding
pain management
rhogam if -
emotional counseling

Question 4

types of abortions

Answer 4

spontaneous
incomplete
complete
threatened (cervix is closed)
missed (no bleeding, no pain)

Question 5

ectopic pregnancy

Answer 5

the fertilized egg implants in a spot other than the endometrial lining

Question 6

symptoms of an ectopic pregnancy

Answer 6

vaginal spotting
lower quadrant pain
possible shoulder pain
abnormally low HCG levels
rigid abdomen, possible hemorrhage
hypovolemic shock
no fetal HR
pregnancy ends

Question 7

management of an ectopic pregnancy

Answer 7

laparoscopy (removal of fallopian tube segment)
laparoscopy (entire fallopian tube)
laparotomy (fallopian tube repair)
-methotrexate
emotional counseling
rhogam if -

Question 8

Hydatiform Mole

Answer 8

abnormal chronic growth replaces the fetus, looks like small fluid filled sacs (grape clusters)

no longer a fetus, just a cluster of cells

Question 9

symptoms of hydatiform mole

Answer 9

excessive vomitting
brown, prune juice colored discharge
no pain
abnormal rapid replication of HCG
abnormally large uterus
no fetal HR
no fetus on ultrasound

Question 10

management of hydatiform mole

Answer 10

suction courettage
monitor HCG levels until 0
avoid pregnancy for 1 year
possible reoccurence or corio
pain management
rhogam if -
emotional counseling

Question 11

gestational diabtetes

Answer 11

caused by HPL

Question 12

maternal clinical manifestations of gestational diabetes

Answer 12

preeclampsia
increased risk for c section
increased risk for type 2 within 5-15 years after birth

Question 13

fetal clinical manifestations of gestational diabetes

Answer 13

store fat - large baby
decreased placental perfusion
fetal demise

Question 14

neonatal clinical manifestations of gestational diabetes

Answer 14

hypoglycemia

Question 15

nursing interventions for gestational diabetes

Answer 15

exercise after meals (low impact- walking, swimming, jogging as tolerated)
carry simple carb snack
wear ID band
hydration (water, NO sports drinks)

Question 16

multiple gestation

Answer 16

monozygotic - identical twins
dizygotic - fraternal twins

Question 17

monozygotic

Answer 17

results from one single ovum
ovum splits after fertilization
shares placenta or amniotic sac

**increased risk for cord entanglement or cord compression

Question 18

dizygotic

Answer 18

results from two separate ovum
2 separate ovum fertilized by 2 separate sperm

Question 19

preterm infant concerns

Answer 19

transparent skin/ thin ruddy
reduced energy
size
decreased muscle tone/ posture
languo/vernix
immature lungs
nutrition concerns
immature immune system
decreased responsiveness

Question 20

preterm infant assessment/ interventions

Answer 20

assess feeding readiness
daily weights
ABC’s
thermoregulation/ controlled temp environment
reposition/ minimize trauma
no excessive wiping
monitor feeding times/ cluster feeding
limit visitors
promote bonding

Question 21

infant oral readiness

Answer 21

intatc feeding reflexes (swallow- suck coordination, and gag)
ability to latch
stomach capacity
immature sphincter
energy
digestive enzyme

Question 22

infant does not have digestive enzymes interventions

Answer 22

NG feeding
intermittent or continuous

*breastmilk (add fortifier)
*formula (special care formula)
*multivitamin

Question 23

infant does have digestive enzymes interventions

Answer 23

prescribed feedings (frequency, amount, duration)
use special nipple

*breastmilk (add fortifier)
*formula (special care formula)
*multivitamin

Question 24

necrotizing enterocolitis (NEC)

Answer 24

due to increased gas and bacteria and decreased perfusion to the gut

Question 25

signs and symptoms or NEC

Answer 25

abdominal distention
bloody diarrhea
feeding intolerance
increased gastric residual

Question 26

NEC assessment and interventions

Answer 26

monitor stools/ bowel sounds
daily abdominal circumference
monitor vital signs
assess feedings/ measure residuals
NPO
antibiotics