Gestational Complications and Preterm labor Flashcards
exam 2
abortion
a pregnancy that does not reach the point of viability (20 weeks gestation)
symptoms of abortion
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)
management of abortion
D+C/ suction courttage for incomplete or missed abortion
monitor bleeding
pain management
rhogam if -
emotional counseling
types of abortions
spontaneous
incomplete
complete
threatened (cervix is closed)
missed (no bleeding, no pain)
ectopic pregnancy
the fertilized egg implants in a spot other than the endometrial lining
symptoms of an ectopic pregnancy
vaginal spotting
lower quadrant pain
possible shoulder pain
abnormally low HCG levels
rigid abdomen, possible hemorrhage
hypovolemic shock
no fetal HR
pregnancy ends
management of an ectopic pregnancy
laparoscopy (removal of fallopian tube segment)
laparoscopy (entire fallopian tube)
laparotomy (fallopian tube repair)
-methotrexate
emotional counseling
rhogam if -
Hydatiform Mole
abnormal chronic growth replaces the fetus, looks like small fluid filled sacs (grape clusters)
no longer a fetus, just a cluster of cells
symptoms of hydatiform mole
excessive vomitting
brown, prune juice colored discharge
no pain
abnormal rapid replication of HCG
abnormally large uterus
no fetal HR
no fetus on ultrasound
management of hydatiform mole
suction courettage
monitor HCG levels until 0
avoid pregnancy for 1 year
possible reoccurence or corio
pain management
rhogam if -
emotional counseling
gestational diabtetes
caused by HPL
maternal clinical manifestations of gestational diabetes
preeclampsia
increased risk for c section
increased risk for type 2 within 5-15 years after birth
fetal clinical manifestations of gestational diabetes
store fat - large baby
decreased placental perfusion
fetal demise
neonatal clinical manifestations of gestational diabetes
hypoglycemia
nursing interventions for gestational diabetes
exercise after meals (low impact- walking, swimming, jogging as tolerated)
carry simple carb snack
wear ID band
hydration (water, NO sports drinks)
multiple gestation
monozygotic - identical twins
dizygotic - fraternal twins
monozygotic
results from one single ovum
ovum splits after fertilization
shares placenta or amniotic sac
**increased risk for cord entanglement or cord compression
dizygotic
results from two separate ovum
2 separate ovum fertilized by 2 separate sperm
preterm infant concerns
transparent skin/ thin ruddy
reduced energy
size
decreased muscle tone/ posture
languo/vernix
immature lungs
nutrition concerns
immature immune system
decreased responsiveness
preterm infant assessment/ interventions
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
infant oral readiness
intatc feeding reflexes (swallow- suck coordination, and gag)
ability to latch
stomach capacity
immature sphincter
energy
digestive enzyme
infant does not have digestive enzymes interventions
NG feeding
intermittent or continuous
*breastmilk (add fortifier)
*formula (special care formula)
*multivitamin
infant does have digestive enzymes interventions
prescribed feedings (frequency, amount, duration)
use special nipple
*breastmilk (add fortifier)
*formula (special care formula)
*multivitamin
necrotizing enterocolitis (NEC)
due to increased gas and bacteria and decreased perfusion to the gut
signs and symptoms or NEC
abdominal distention
bloody diarrhea
feeding intolerance
increased gastric residual
NEC assessment and interventions
monitor stools/ bowel sounds
daily abdominal circumference
monitor vital signs
assess feedings/ measure residuals
NPO
antibiotics
