High Risk Antepartum

Question 1

complications of GDM

Answer 1

macrosomia, shoulder dystocia, newborn hypoglycemia

Question 2

miscarriage complications

Answer 2

hemorrhage, infection, isoimmunization

Question 3

ectopic pregnancy s/s

Answer 3

positive pregnancy test at first

Question 4

ectopic rupture s/s

Answer 4

if in fallopian tubes - sharp unilateral pain, bleeding

Question 5

ectopic pregnancy tx

Answer 5

immediate surgery to avoid rupture & hemorrhage

Question 6

gestational trophoblastic disease

Answer 6

nonviable egg implants, will not progress

Question 7

molar pregnancy s/s

Answer 7

positive pregnancy test at first, then negative

Question 8

what is placenta previa

Answer 8

complete/partial coverage of the uterine opening by the placenta

Question 9

s/s of placenta previa if labor occurs

Answer 9

painless, bright red vaginal bleeding

Question 10

nursing interventions for placenta previa

Answer 10

hypovolemia/hemorrhage interventions
bedrest, pad count, no vaginal exams

Question 11

treatment for placenta previa

Answer 11

C-section

Question 12

what is a placental abruption?

Answer 12

placenta detaches from uterine wall

Question 13

s/s of a placental abruption

Answer 13

sharp, stabbing pain; rigid, board like abdomen

Question 14

risk factors for placental abruption

Answer 14

trauma, cocaine use, chorio, high parity, AMA

Question 15

nursing interventions for placental abruption

Answer 15

hypovolemia/hemorrhage interventions
draw coags
bedrest, pad counts

Question 16

why is it important to draw coags with a placental abruption?

Answer 16

highly associated with DIC

Question 17

placental abruption interventions

Answer 17

vaginal delivery unless fetus is unwell

Question 18

management of preterm labor

Answer 18

bedrest, IV fluids, ext. monitoring, vaginal cervical and urine cultures

Question 19

medications for PTL

Answer 19

tocolytics - terbutaline, nifedipine
mag sulf if under 32 weeks
betamethasone

Question 20

purpose of tocolytics in PTL

Answer 20

halts labor

Question 21

purpose of mag sulf in PTL

Answer 21

fetal neuroprotection

Question 22

purpose of betamethasone in PTL

Answer 22

increases fetal lung maturity

Question 23

causes of PROM

Answer 23

usually chorio

Question 24

PROM management before 34 weeks

Answer 24

betamethasone, mag sulf, antibiotics, BPP/NST, monitor for labor and infection

Question 25

PROM management after 34 weeks

Answer 25

birth

Question 26

s/s of chorio

Answer 26

fever, high HR, uterine tenderness, discolored, foul smelling amniotic fluid

Question 27

gestational HTN

Answer 27

new onset HTN, no proteinuria, typically resolves after birth

Question 28

chronic HTN with SIPE

Answer 28

pre-e in a woman with preexisting HTN

Question 29

pre-eclampsia without severe features s/s

Answer 29

BP 140/90, +1/+2 proteinuria, mild edema, weight gain

Question 30

pre-eclampsia with severe features s/s

Answer 30

BP 160/110, +3/+4 proteinuria, visual changes, pulmonary/cardiac issues, edema, hyperreflexia, mid-epigastric pain (liver issues)

Question 31

eclampsia

Answer 31

seizures, coma

Question 32

interventions for pre-e

Answer 32

fetal monitoring, seizure precautions, freq BPs, LFTs, BUN, Cr, fluids, critical I&Os

Question 33

medications for pre-e

Answer 33

magnesium sulfate, antihypertensives

Question 34

antihypertensives for pre-e

Answer 34

labetalol, hydralazine if severe

Question 35

magnesium sulfate considerations

Answer 35

assess reflexes, critical I&Os, keep calcium gluconate on standby

Question 36

treatment for HELLP

Answer 36

bedrest, monitoring, blood, antihypertensives, corticosteroids if preterm, mag sulf