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OB > HIGH RISK ANTEPARTUM - FINAL EXAM > Flashcards

HIGH RISK ANTEPARTUM - FINAL EXAM Flashcards

1
Q

placenta previa

A

low lying placenta blocking exit requiring c/s

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2
Q

risk factors of previa

A

endometrial scarring, increased placenta mass, mutli c/s

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3
Q

previa risks to women

A

shock, blood loss, Rh sensitization, death

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4
Q

previa risks to fetus

A

prematurity, anemia, hypoxia, compromise

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5
Q

s/s of previa

A

painless bright red vag bleeding, FHR changes

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6
Q

nursing actions of previa

A

monitor labs, bleeding, assess pain, IV, meds

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6
Q

manage previa

A

ultrasound, c/s, monitor bleeding

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7
Q

placental abruption

A

maternal bleeding causing detachment of placenta before delivery

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8
Q

s/s of placental abruption

A

vag bleeding, pain, hypertonic contractions, uterine tenderness, nonreassuring FHR

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9
Q

risk factor of placental abruption

A

cocaine/heroin use, hx of abruption, hypertensive, trauma

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10
Q

abruption risks to women

A

blood loss, death, renal failure

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11
Q

abruption risk to fetus

A

premature, asphyxia, death

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12
Q

manage abruption

A

betameth, steriods

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13
Q

nursing action of abruption

A

s/s, FHR monitor, report blood loss, palpate uterus, oyxgen/IV

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14
Q

acreta

A

placenta goes beyond boundaries and invades wall

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15
Q

increta

A

placenta goes deeper into uterine wall

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16
Q

percreta

A

placenta goes beyond uterine wall and attaches to bladder (other organs)

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17
Q

accreta risks to women

A

hemorrhage, shock, blood loss, infection

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18
Q

accreta risks to fetus

A

prematurity

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19
Q

management of accreta

A

delivery, hysterectomy

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20
Q

nursing actions of accreta

A

monitor labs, support

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21
Q

ectopic preg

A

egg implants outside of uterus, nonviable preg

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22
Q

s/s of ectopic preg

A

pelvic pain, bleeding, weak/dizzy

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23
Q

manage ectopic preg

A

assess HCG levels, metotrexate, medically induced abortions

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24
Q

gestational trophoblastic disease

A

abnl trophoblast cells grow inside uterus
nonmolar: benign
molar: cancerous

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25
Q

interventions of trophoblastic disease

A

no sex for up to 1 yr

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26
Q

substance use on baby

A

lbw, developmental disability, PTB, death

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27
Q

hyperemesis gravidarum

A

excessive vomiting from hormone excess

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28
Q

hyperemesis leads to

A

dehydration, fluid/electrolyte imbalance, wt loss, ketonuria

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29
Q

hyperemesis time frame

A

peaks at 9 wks ends around 20 wks w decrease in HCG and increase in HCS

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30
Q

nursing actions of hyperemesis

A

treat N/V, labs, I/O, weight, oral hygiene

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31
Q

intrahepatic cholestasis

A

pruritis of hands and feet due to uric acid and bile duct backup and breakdown in liver

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32
Q

causes of intrahepatic cholestasis

A

PTB, meconium, FHR abnl, death

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33
Q

cholestasis risks to fetus

A

elevated serum bile levels, stillbirth

34
Q

manage cholestasis

A

antihistamines, NST/BPP, must delivery at 36 wks

35
Q

gestational diabetes

A

caused by increase HCS, GMDA1: treated by diet/exercise, GMDA2: treated by insulin

36
Q

glucose changes in preg

A

insulin resistance, hormone shifts, glucose sparing for baby

37
Q

goals of diabetes

A

maintain euglycemia, minimize comps, prevent prematurity

38
Q

risk to women for pregestational diabetes

A

preeclampsia, diabetic ketoacidosis, abortion, poly/oligohydraminos, c/s, PPH, infection

39
Q

risks to fetus for pregestational diabetes

A

macrosomia, congential defects, IUGR, resp distress, polycythemia, premature, death

40
Q

manage pregestational diabetes

A

HBA1C, screening kidneys, ultrasound, nutrition therapy

41
Q

risks during delivery of pregestational diabetes

A

transient trachypnea (fluid in lungs), resp distress, hypoglycemia

42
Q

gestational diabetes test GTT (24-28 wks)

A

1 hr test have 50g drink and test, if above 140 do 3 hr test, 100g drink test hrly, if still 140 = diabetes

43
Q

gestational diabetes risk for women

A

hypoglycemia, DKA, preeclampsia, c/s, nongestational diabetes

44
Q

gestational diabetes risk to fetus

A

macrosomia, IUGR, hypoglycemia, hyperbilirubinemia, shoulder dystocia, resp distress

45
Q

manage gestational diabetes

A

c/s, diet/exercise/insulin, monitor for type 2

46
Q

preeclampsia

A

HTN after 20 wks w proteinuria
140/90 and higher
160/110 is severe

47
Q

risk factors for preeclampsia

A

nulliparity, under 20 over 35, multi gestation, hypertension, gestational diabetes, fam hx

48
Q

preeclampsia risks to women

A

DIC, CHR, HELLP, seizures, pain, vision changes, hemorrhage, sroke, PE

49
Q

preeclampsia risk to fetus

A

IUGR, premature, death, intolerant to labor

50
Q

presenting pt w preeclampsia

A

140/90 - 160/110, proteinuria, headache, vision changes, pain

51
Q

manage preeclampsia

A

mag sulfate, induce labor

52
Q

eeclampsia s/s

A

severe headache that wont go away, pain, restless, seizures, confusion, hyperreflexia w clonus

53
Q

post seizure care of eeclampsia

A

assess maternal/fetal status, admin O2/IV, mag

54
Q

HELLP

A

hemolysis, elevated liver enzymes, low platelets

55
Q

PTL

A

regular contractions to change cervix and uterus

56
Q

extreme preterm

A

less than 28 wks

57
Q

very preterm

58
Q

mod to late preterm

59
Q

factors of PTL

A

uterine stretching, decidual activation, infection, maternal/fetal stress, hx of PTL

60
Q

viabil PTB

A

25wks plus and able to survive outside the womb

61
Q

peri viabil PTB

A

before 25 wks with low chance of survival

62
Q

risks of PTB

A

hx of PTB, multiple gestation, uterine/cervical abnl

63
Q

fetal fibronectin

A

detected in vagina, if present there is risk of delivery in 1-2wks

64
Q

maternal risk for PTB

A

cardiac arrhytmias, PE, CHF

65
Q

fetal risk for PTB

66
Q

not stopping labor for

A

intrauterine fetal demise, lethal fetal anomaly, non reassuring fetal status, chorioamniotitis, preeclampsia

67
Q

PROM/PPROM

A

premature or preterm premature rupture of membranes

68
Q

risk factors of PROM/PPROM

A

hx, bleeding, STI, multi gestation, hydramnios, short cervix length

69
Q

manage PROM before 32 wks

A

neuroprotection w mag sulfate

70
Q

manage PROM fore 34 wks

A

reduce infection, corticosteriods

71
Q

manage PROM after 34 wks

A

induce labor

72
Q

nursing actions of PROM/PPROM

A

assess FHR/contractions, assess for infection, NST, BPP

73
Q

cervical insufficiency

A

painless cervical dilation and explusion preg

74
Q

causes of cervical insufficiency

A

hx of cervical trauma, D/C, lacerations, LEEP, abnl cervical development, PTB

75
Q

manage cervical insufficiency

A

activity, rest, pessary, cerclage, birth at 37 wks

76
Q

nursing actions post cerclage

A

monitor uterine activity, vaginal bleeding/LOF, monitor for infection

77
Q

monozygotic twins

A

1 zygote that divides in 1st wk with increase risk of cord entanglement and twin/twin transfusion

78
Q

dizygotic twins

A

2 fertilizations

79
Q

multigestation risks to women

A

hypertensive disorderes, hemorrhage, gestational diabetes, anemia, cholestasis, c/s

80
Q

multi gestation risks to fetus

A

PTB, death, prematurity, twin/twin transfusion, IUGR, congenital defects

81
Q

s/s of mutli gestation

A

increase HCG levels, higher fundal ht, high CO and BV, iron deficiency anemia

82
Q

management of multi gestation

A

genetic testing, NST, BPP, s/s of PTB, s/s of anemia, hypertensive disorders

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