Gestational Conditions

Question 0

When can you do a SVE on a woman who comes in complaining of bleeding?

Answer 0

After an ultrasound

Question 1

How do you measure blood loss?

Answer 1

Grams - Ounces

3000 grams - 1 oz

Question 2

SAB

Answer 2

Spontaneous Abortion (miscarriage)

Question 3

EAB

Answer 3

Elective abortion

Question 4

Imminent abortion

Answer 4

1st trimester
Unstoppable- an abortion will occur
Bleeding, cervical changes, cramping

Question 5

Threatened abortion-

Answer 5

Abortion could occur- 1st trimester
Bleeding, cramping, no cervical changes
Use tocolytics, bed rest, mother becomes high risk pregnancy for the remaining pregnancy

Question 6

Complete vs. Incomplete Abortion

Answer 6

Complete- all parts of conception are ejected from body

Incomplete- may need DNE

Question 7

Reoccur-ant abortion

Answer 7

3 pregnancies in a row

Question 8

Missed abortion

Answer 8

baby dies inutero

Question 9

Late abortion

Answer 9

abortion that occurs 24 wks into pregnancy

Question 10

Highest concerns after an abortion

Answer 10

Hemorrhage

Infection

Question 11

Ectopic pregnancy

Answer 11

Usually not a good outcome
Indications of rupture- pain, hard blue stomach
Methotrexate- folic acid antagonist- disrupts cell division rapidly if rupture has not already occurred

Question 12

Hydratiform Mole

Answer 12

Cells take over
Indications- too high fundal height, no FHT, hyperemisis***
DO NOT get pregnant for a year afterwards- strict birth control for a year
Could result in hysterectomy
At risk for seizure

Question 13

Incompetent cervix

Answer 13

2nd trimester
bleeding, dilation, pain-increased pelvic pressure, ROM
McDonald Sutures
High Risk pregnancy precautions

Question 14

Placenta previa

Answer 14

3rd trimester
occurs in first trimester S&S occur in third- baby is too low laying in uterus
risks >35yo, smoker, previous c-section, multiple gestation
delivery- vaginal if possible, c-sections with classical incision, monitor infant for fluid needs, mom may need a transfusion-lower than normal wound
NO PAIN

Question 15

Abruptio placenta

Answer 15

3rd trimester
placenta detaches
late decels, pain, bleeding is not always present
Risks: multip, PIH, Cocaine use,

Question 16

PIH S&S

Answer 16

Increase systolic of >30
increase diastolic >15
high weight gain r/t edema
kidney problems- protein in urine
hyperflexia
visual changes

Question 17

PIH risk factors

Answer 17

19-40
multi gestation
obesity
family hx
chronic renal 
hypertension

Question 18

Vasospasm PIH

Answer 18

decrease blood flow to organs- mainly affecting uterus and kidneys in pregnancy

Question 19

PIH intervention

Answer 19

flat lying LL side
strict I&O urine 30ml/hr
diet
magnesium sulfate

Question 20

Magnesium Sulfate

Answer 20

cathartic- pulls water, decreases edema, causes diarrhea
CNS depressant- monitor RR(no less than 12)
Antidote Ca
Apresoline- anti-hypertensive

Question 21

HELLP

Answer 21

Hemolysis
Elevated Liver
Lower platelets

Epigastric pain
Avoid cuts
Monitor IV

> 25yo
white
muliparas

Question 22

DIC

Answer 22

PIH- HELLP- DIC

DIC your mom is in trouble

Question 23

DIC what happens

Answer 23

blood goes to every orafice

caused by trauma

Question 24

DIC tx

Answer 24

Assess clotting factors
Cure injury
Replace volume
Get baby out ASAP
Monitor I&O

Question 25

TORCH

Answer 25

Toxoplasmosis- flu like- do not change litter box
Other
Hep B— preterm labor give baby Hep Big
HIV — C/S, no breast feeding, go immediately to hospital upon ROM
Rubella makes mom itchy
CMV- do not get pregnant during outbreaks
Herpes

Beta Hemalytic Strep- culture during pap tx antibiotic both mom and partner